Mtundu wa shuga wa matenda a shuga: ndi chiyani komanso momwe mungachitire

Matenda a Steroid a shuga (mtundu 1 wa matenda ashuga) ndi mtundu wa matenda ashuga omwe amayamba chifukwa cha kuchuluka kwa mahomoni monga corticosteroids m'magazi. Nthawi zina zimatha kuwoneka ngati zovuta pambuyo pa matenda ena omwe amagwirizana ndi kupanga insulin. Komabe, monga lamulo, matendawa amayamba kuonekera atagwiritsidwa ntchito kwa nthawi yayitali mankhwala ena. Chifukwa cha chifukwa ichi, matendawa amatchedwanso matenda a shuga.

Mankhwala Omwe Angayambitse

Mankhwala a Glucocorticoid, mwachitsanzo, dexamethasone, hydrocortisone, prednisone amagwiritsidwa ntchito ngati mankhwala odana ndi kutupa omwe amagwiritsidwa ntchito pochiza:

Matenda a shuga a Steroid amadziwonetsera, ngati lamulo, akamamwa mankhwala okodzetsa:

Mapiritsi othandizira kubereka
Thiazide diuretics: nephrix, hypothiazide, Navidrex.

Mlingo wawukulu wa corticosteroids amagwiritsidwanso ntchito ngati anti-yotupa pakumala opaleshoni kuthira chiwalo monga impso.

Pambuyo pa opaleshoni, odwala onse amafunika kumwa mankhwalawa kuti akhale osatetezeka. Anthu oterewa amatha kutenga matenda mosavuta, makamaka, monga lamulo, gulu lopereka limavutika.

Matenda a Steroid samakula mwa odwala onse. Komabe, ndimagwiritsidwe ntchito angagwiritsidwe ntchito ka mankhwala a horoni pomwe pamakhala chiopsezo cha matendawo.

Kuti mupewe matendawa, muyenera kuchepa thupi, kuyamba kuwunika kulemera kwanu, kuchita masewera olimbitsa thupi komanso kusintha zakudya zanu.

Ngati munthu akudziwa za tsogolo la matenda ashuga, musalole kuti akupatseni mankhwala omwe mungamwe. Mankhwalawa amatha kuvulaza thupi.

Mawonekedwe

Matenda a steroid alibe mawonekedwe.

Zizindikiro monga kumangokhala ndi ludzu komanso kuwonjezeka kwa shuga mu mkodzo ndizosawoneka. Kuphatikiza apo, kusinthasintha kwa shuga kulinso kosawonekera. Monga lamulo, matendawa amapitilira modekha popanda zizindikiro zoonekeratu. Pali zingapo kusiyanitsa matendawa: kufooka kwathupi la thupi, kutopa, komanso thanzi. Komabe, zizindikirozi zimapezeka mwa odwala omwe ali ndi matenda osiyanasiyana. Mawonekedwe oterewa amatha kuwonetsa bwino mu adrenal cortex.

Ndi mtundu wamtunduwu wa shuga, ndizosowa kwambiri kuwona fungo la acetone kuchokera mkamwa, koma izi zimachitika pamene matendawa ali kumapeto komaliza. Nthawi zambiri, ma ketoni amapezeka mumkodzo. Kuphatikiza apo, nthawi zambiri zotsatirapo zimachitika, chifukwa chake zimakhala zovuta kusankha chithandizo chamankhwala choyenera. Ichi ndichifukwa chake zizindikiro zimasinthidwa pogwiritsa ntchito zakudya komanso katundu wochepa thupi.

Kodi angachiritsidwe bwanji?

Chithandizo cha matenda amtunduwu matenda a shuga ndikuti akhazikitse:

Mwazi wamagazi wodwala
Kuthetsa zoyambitsa zomwe zidathandizira kukulira kwa corticosteroids mu adrenal cortex.

Zimachitika pamene wodwala akufunika opaleshoni: minofu yowonjezera mu adrenal gland imachotsedwa mu njira yothandizira. Njira zotere zimayendetsa bwino matendawa, ndipo nthawi zina matendawa amatha, zomwe zimapangitsa shuga kukhala yabwinobwino. Makamaka zoterezi zimatheka ngati mumatsatira zakudya No. 9, zomwe zimapangidwira cholesterol yayikulu kapena kuchepetsa kunenepa.

Mankhwala akutenga mankhwala ofunikira omwe amachepetsa shuga la magazi.

Pa gawo loyamba la chithandizo, adotolo amafotokozera mankhwala a sfanfanilurea, komabe, amachepetsa kagayidwe kazakudya m'thupi la wodwalayo. Pankhaniyi, matendawa amasinthana ndi mtundu wokhazikika wa insulin. Kuwunikira pafupipafupi ma kilogalamu anu ndi gawo limodzi lofunikira kwambiri la chithandizo. Izi ndichifukwa choti ngati kulemera kumakulirakulira, ndiye kuti matendawa adzayamba kulimba.

Muyenera kusiya mankhwalawa, chifukwa chake matendawa adayamba. Monga lamulo, dokotala pankhaniyi amasankha ma analogi osakhudza thupi la wodwalayo. Madokotala ambiri amalimbikitsa kuphatikiza chithandizo ndi mapiritsi okhala ndi jakisoni. Njira yothandizira mankhwalawa imachulukitsa kangapo mwayi wobwezeretsa maselo a pancreatic, omwe amachititsa kuti insulini ipangidwe. Pambuyo pa gawo ili, nthawi ya matendawa imawoneka kuti ikhoza kuwongolera powona zakudya.

Njira zilizonse zochizira matenda a shuga a steroid ziyenera kuvomerezedwa ndi dokotala.

Matenda a Steroid: Zizindikiro, matenda ndi njira zochizira

Zomwe zimapangitsa kuti shuga achulukane zimatha kukhala zochulukirapo kwa nthawi yayitali m'madzi. Pankhaniyi, kupezeka kwa matenda a shuga a steroid amapangidwa. Nthawi zambiri, kusowa bwino kwa mankhwalawa kumachitika chifukwa cha mankhwalawa, koma kungakhale kuphatikizanso kwa matenda omwe amachititsa kuti mahomoni azitha kutulutsa. Nthawi zambiri, kusintha kwa zamankhwala mu kagayidwe kazakudya kumatha kusintha, pambuyo pochotsa mankhwala kapena kukonza matendawo, amatha, koma nthawi zina amatha kulimbikira atalandira chithandizo.

Ma steroid owopsa kwambiri kwa anthu omwe ali ndi matenda ashuga a 2. Malinga ndi ziwerengero, 60% ya odwala amayenera kusintha m'malo mwa hypoglycemic othandizira ndi insulin.

Steroidal kapena mankhwala a shuga ndi matenda omwe amatsogolera ku hyperglycemia. Cholinga chake ndi zotsatira zoyipa zamahomoni a glucocorticoid, omwe amagwiritsidwa ntchito kwambiri munthambi zonse zamankhwala. Amachepetsa ntchito ya chitetezo chathupi, amakhala ndi zotsutsa-zotupa. Glucocorticosteroids akuphatikiza Hydrocortisone, Dexamethasone, Betamethasone, Prednisolone.

Posachedwa, osaposa masiku 5, chithandizo cha mankhwalawa chimaperekedwa kwa matenda:

zotupa zoyipa
bakiteriya meningitis
COPD ndi matenda osatha a m'mapapo
gout mu pachimake siteji.

Kutalika kwa nthawi yayitali, kupitirira miyezi isanu ndi umodzi, mankhwala a steroid angagwiritsidwe ntchito pneumonia yapakati, matenda a autoimmune, kutupa kwamatumbo, zovuta zamkati, komanso kufalikira kwa ziwalo. Malinga ndi ziwerengero, kuchuluka kwa anthu odwala matenda ashuga atatha kugwiritsa ntchito mankhwalawa sikupitirira 25%. Mwachitsanzo, pochiza matenda am'mapapo, hyperglycemia imawonedwa mu 13%, mavuto a pakhungu - 23,5% ya odwala.

Chiwopsezo cha matenda a shuga a steroid chikuwonjezeka ndi:

makonzedwe otengera mtundu wa shuga, achibale oyamba omwe ali ndi matenda ashuga,
matenda a shuga gestational panthawi imodzi yapakati,
prediabetes
kunenepa kwambiri, makamaka pamimba
ovary polycystic,
ukalamba.

Mulingo waukulu wa mankhwala omwe amamwa, ndiwomwe umakhalapo ndi matenda a shuga a steroid:

Matendawa amapatsidwa nambala ya ICD ya 10 E11 ngati chikhodzodzo chimasungidwa pang'ono, ndipo E10 ngati maselo a beta adawonongedwa kale.

Odwala onse omwe amamwa ma steroid ayenera kudziwa zomwe zimayambitsa matenda ashuga:

polyuria - kukodza pokodza,
polydipsia - ludzu lamphamvu, pafupifupi osafooka mukamwa,
nembanemba youma, makamaka pakamwa,
khungu lakuthwa, losasamala
wotopa nthawi zonse, kuchepa kwa ntchito,
ndi kuchepa kwakukulu kwa insulin - kuchepa thupi kosalephera.

Ngati zizindikirozi zikuchitika, ndikofunikira kuzindikira matenda a shuga. Kuyesedwa kovuta kwambiri pankhaniyi ndi kuyesa kwa glucose. Nthawi zina, zimatha kuwonetsa kusintha kwa kagayidwe kazakudya mkati mwa maola 8 atatha kumwa ma steroids. Njira zoyesera ndizofanana ndi mitundu ina ya matenda ashuga: shuga kumapeto kwa kuyesedwa sikuyenera kukhala kwakukulu kuposa 7.8 mmol / l. Ndi kuchuluka kwa kuchuluka kwa magawo 11.1, titha kulankhula za kusokonezeka kwakukulu kwa metabolic, nthawi zambiri kosasinthika.

Kunyumba, shuga ya shuga imatha kupezeka pogwiritsa ntchito glucometer, mulingo wapamwamba kwambiri 11 mutatha kudya chikusonyeza kuyambika kwa matendawa. Kuthamanga shuga kumakula pambuyo pake, ngati ndizopamwamba kuposa mayunitsi 6.1, muyenera kulumikizana ndi endocrinologist kuti mupeze zowonjezera ndi kulandira chithandizo.

Kodi mumazunzidwa ndi kuthamanga kwa magazi? Kodi mukudziwa kuti matenda oopsa amathanso kukopeka ndi mtima ndi kumenyedwa? Sinthani nkhawa zanu. Maganizo ndi mayankho okhudza njira zomwe mwawerenga apa >>

Zizindikiro za matenda opha shuga a shuga sangakhalepo, chifukwa chake, ndichikhalidwe chake kuyendetsa shuga m'magawo awiri oyamba pambuyo pa kukhazikitsidwa kwa glucocorticoid. Pogwiritsa ntchito mankhwala kwa nthawi yayitali, mwachitsanzo, mutabadwa, kuyesedwa kumaperekedwa sabata iliyonse mwezi woyamba, kenako pambuyo pa miyezi itatu ndi miyezi isanu ndi umodzi, mosasamala kanthu za kukhalapo kwa zizindikiro.

Matenda a shuga a Steroid amachititsa kuchuluka kwa shuga atatha kudya. Usiku ndi m'mawa musanadye, glycemia ndiyachilendo kwa nthawi yoyamba. Chifukwa chake, chithandizo chomwe chikugwiritsidwa ntchito chiyenera kuchepetsa shuga masana, koma osayambitsa hypoglycemia yausiku.

Zochizira matenda a shuga, mankhwalawa omwe amagwiritsidwa ntchito ngati mitundu ina ya matendawa: othandizira a hypoglycemic ndi insulin. Ngati glycemia ali ochepera 15 mmol / l, chithandizo chimayamba ndi mankhwala omwe amagwiritsidwa ntchito ngati mtundu 2 wa shuga. Manambala ambiri a shuga amawonetsa kuwonongeka kwakukulu pancreatic ntchito, odwala oterewa amapatsidwa jakisoni wa insulin.

Matenda a Steroid ndi matenda oopsa, omwe ndi mtundu wa matenda ashuga. Dzinalo lina ndi shuga wachiwiri wodwala insulin. Matendawa amafunika kukhala ndi chidwi chachikulu ndi wodwalayo. Matenda a shuga amtunduwu amayamba chifukwa cha kugwiritsidwa ntchito kwa nthawi yayitali kwa mankhwala ena a mahomoni, motero amadziwika kuti matenda osokoneza bongo.

Matenda a shuga a sodiumid amatanthauza matenda omwe amapezeka m'chilengedwe. Ndiye kuti, sizimakhudzana ndi mavuto mu kapamba. Odwala omwe ali ndi vuto lodana ndi kagayidwe kazakudya, koma akhala akugwiritsa ntchito glucocorticoids (mahomoni opangidwa ndi ma adrenal gland) kwa nthawi yayitali, amatha kudwala matenda a shuga a steroid, omwe ndi ofatsa.

Kuwonetsedwa kwa matendawa kumatha munthu atasiya kumwa mankhwala a mahomoni. Mu 60 peresenti ya odwala omwe ali ndi matenda a shuga a 2, matendawa amabwera chifukwa chakuti odwala amasintha kupita ku insulin. Kuphatikiza apo, matenda a shuga amatha kukhala ngati vuto la matenda omwe munthu amawonjezera kupanga kwa mahomoni mu adrenal cortex, mwachitsanzo, hypercorticism.

Ndi mankhwala ati omwe angayambitse matenda ashuga?

Zomwe zimayambitsa matenda a shuga a steroid zimatha kukhala kugwiritsa ntchito nthawi yayitali mankhwala a glucocorticoid, omwe amaphatikizapo "Dexamethasone", "Prednisolone", komanso "Hydrocortisone". Mankhwalawa ndi mankhwala othana ndi kutupa omwe amathandizira kuchiritsa mphumu ya bronchial, nyamakazi, komanso matenda ena a autoimmune, omwe amaphatikizapo pemphigus, lupus erythematosus, ndi eczema. Komanso mankhwalawa amagwiritsidwa ntchito pochiza matenda oopsa a m'mitsempha ngati ziwongo zambiri.

Kuphatikiza apo, matenda osokoneza bongo amatha kuchitika chifukwa chogwiritsa ntchito mapiritsi oletsa kubereka a mahomoni, komanso ma thiazide diuretics, omwe ndi okodzetsa. Mankhwalawa akuphatikizapo "Dichlothiazide", "Hypothiazide", "Nephrix", "Navidrex".

Matenda a Steroid amathanso kuchitika mwa anthu atabadwa impso. Anti-kutupa mankhwala pambuyo kupatsidwa chiwalo pamafunika kwakanthawi makonzedwe akuluakulu a corticosteroids, kotero odwala ayenera kumwa mankhwala moyo kuti athetse chitetezo chokwanira. Komabe, matenda a shuga a steroid samapezeka mwa odwala onse omwe amachitidwa opaleshoni yamphamvu kwambiri, koma mwayiwu ndiwokwera kwambiri chifukwa chogwiritsa ntchito mahomoni kuposa momwe amathandizira matenda ena.

Ngati munthu wakhala akugwiritsa ntchito mankhwala a steroid kwa nthawi yayitali ndipo ali ndi zizindikiro za matenda ashuga, izi zikuwonetsa kuti wodwalayo ali pachiwopsezo. Popewa matenda a shuga a steroid, anthu onenepa kwambiri ayenera kuchepetsa thupi ndi kusintha moyo wawo, kuchita zolimbitsa thupi zopepuka. Ngati munthu ali ndi matenda, amakhala oletsedwa kutenga mahomoni kutengera zomwe adazilingalira.

Matenda osokoneza bongo amadziwika chifukwa amaphatikiza zizindikilo za mitundu yonse iwiri ya matenda ashuga. Kumayambiriro koyambirira kwa matendawa, corticosteroids ambiri amayamba kuwononga maselo a beta omwe amapezeka m'matumbo. Zizindikiro zoterezi ndizofanana ndi matenda ashuga 1. Ngakhale izi, insulin m'maselo a beta ikupitilirabe kubayidwa. Pakapita kanthawi, misempha ya insulin imayamba kutsika, ndipo minofu yake imayamba kuchepa mphamvu iyi. Zizindikirozi ndizodziwika ndi matenda amtundu wa 2. Pakapita nthawi, ma cell a beta amayamba kuwonongeka. Zotsatira zake, kupanga insulin kumayima. Matenda a shuga omwe amadalira insulin a mtundu woyamba amakhalanso chimodzimodzi.

Zizindikiro za matenda a shuga a steroid ndi ofanana ndi mitundu ina ya matenda ashuga. Munthu amadwala kwambiri komanso amakonda kukodza pafupipafupi, amavutika ndi ludzu, ndipo kumva kutopa kumawonekera mwachangu kwambiri. Zizindikiro zotere za matendawa nthawi zambiri zimakhala zofatsa kwa odwala, motero samazilabadira. Mosiyana ndi matenda amtundu wa 1 shuga, odwala sataya thupi mwadzidzidzi. Madokotala samazindikira nthawi zonse matenda a shuga ngakhale wodwala atakayezetsa magazi. Kuchuluka kwa shuga mu mkodzo ndi magazi ndizosowa kwambiri. Kuphatikiza apo, ziwerengero za acetone mu kusanthula kwa odwala zimapezekanso pazochitika zokhazokha.

Kupanga kwa insulin komwe kumayima m'thupi la munthu, matenda a shuga a steroid amafanana ndi matenda amtundu woyamba, ngakhale ali ndi mawonekedwe a wachiwiri (minofu insulin). Matendawa amathandizidwa monga momwe amachitira shuga 2. Inde, zonse zimatengera mtundu wamatenda omwe wodwala amakhala nawo. Ngati wodwala ali ndi mavuto olemera, koma insulini ikupitilizidwa kupanga, ndiye kuti ayenera kutsatira zakudya komanso kugwiritsa ntchito mankhwala ochepetsa shuga, mwachitsanzo, Thiazolidinedione kapena Glucofage.

Zikondazo zikayamba kugwira ntchito kwambiri, timalimbikitsidwa kubaya insulin, yomwe ingathandize kuchepetsa mtolo pa chiwalocho. Ngati ma cell a beta sanatheretu, ndiye pakapita nthawi, kapamba amabwerera mwakale. Pa ntchito yomweyi, madokotala amapatsa odwala zakudya zamagulu ochepa. Odwala omwe alibe mavuto onenepa kwambiri ayenera kutsatira zakudya No. 9. Kwa iwo onenepa kwambiri, madokotala amalimbikitsa kudya No. 8.

Mawonekedwe a chithandizo pamene insulin siyipangidwa

Chithandizo cha matenda a shuga a steroid zimatengera ngati pancreatic insulin imapangidwa kapena ayi. Ngati mahomoniwa asiya kupangidwa m'thupi la wodwalayo, ndiye kuti amawayika ngati jakisoni. Kuti mankhwalawa akhale othandiza, wodwala ayenera kuphunzira momwe angapangire jakisoni wa insulin. Magazi a shuga amayenera kuyang'aniridwa nthawi zonse. Chithandizo cha matenda a shuga chimapitirira monga momwe zimakhalira ndi matenda ashuga 1. Koma ma cell a beta samabwezedwanso.

Pali milandu ina yomwe munthu amathandizidwa ndi matenda a shuga a steroid, mwachitsanzo, ngati ali ndi mphumu kwambiri kapena atachitidwa opaleshoni ya impso.Zikatero, chithandizo chamankhwala cha mahomoni ndichofunikira, ngakhale kuti wodwalayo amadwala matenda a shuga. Miyezo ya shuga imayenera kusamalidwa potengera momwe kapamba amagwirira ntchito bwino. Kuphatikiza apo, akatswiri amatenga chidwi cha minyewa ya insulin. Muzochitika izi, odwala amapatsidwa mahomoni a anabolic, omwe amawonjezera othandizira thupi, komanso amawongolera mphamvu ya glucocorticoids.

Munthu amakhala ndi kuchuluka kwa mahomoni a adrenal, omwe amasiyanasiyana mosiyanasiyana mu iliyonse. Koma si anthu onse omwe amamwa glucocorticoids omwe ali pachiwopsezo cha matenda ashuga. Corticosteroids imakhudza magwiridwe antchito a kapamba, kuchepetsa mphamvu ya insulin. Pofuna kukhalabe ndi shuga mu magazi, kapamba amayenera kulimbana ndi katundu wolemera. Ngati wodwalayo ali ndi zizindikiro za matenda a shuga a steroid, izi zikutanthauza kuti minofu yake yayamba kuchepa kwambiri ndi insulin, ndipo zimavuta kuti gland igwire ntchito yake.

Chiwopsezo chokhala ndi matenda a shuga chimachulukitsa munthu akakhala ndi vuto lolemera, amamwa mankhwala a steroid mumadontho akulu kapena kwa nthawi yayitali. Popeza zizindikiro za matendawa sizimawoneka posachedwa, anthu okalamba kapena onenepa kwambiri ayenera kupimidwa kuti apezeke ngati ali ndi mtundu wina wa matenda ashuga asanayambe chithandizo cha mahomoni, popeza kumwa mankhwala ena kumatha kudzetsa matendawa.

Kuti magazi a shuga abwerere mwakale, muyenera kudya supuni imodzi m'mawa pamimba yopanda kanthu.

Kukula ndi kugwiritsa ntchito ma steroid mu 1940 kunakhala chozizwitsa chamakono m'njira zambiri. Anathandizira kuchira msanga kwa odwala ambiri omwe ali ndi matenda osiyanasiyana.

Ma Steroid amatsogolera ku zotsatirazi:

kuchuluka kwa shuga amkaka,
kutsitsa shuga
kuphwanya kapangidwe ka zinthu zogwiritsidwa ntchito ndi maselo a beta komanso kuponderezedwa kwa lipolysis.

Kuwonongeka kwa pancreatic dysfunction ya islet insulin yopanga ma cell kwatsimikizidwanso.

Matenda a shuga a Steroid amatanthauzidwa kuti ndi kuchuluka kwachilendo kwa glycemia komwe kumakhudzana ndi kugwiritsa ntchito glucocorticoids mwa wodwala wokhala ndi kapena wopanda mbiri yakale ya matenda omwe amadalira insulin. Njira zoyenera kudziwa mtundu wa matenda amtunduwu ndi kutsimikiza kwa glycemia:

pamimba yopanda kanthu - ochepera 7.0 mmol / l,
patatha maola awiri ndikuyesa pakamwa - - 11.1 mmol / l,
kwa odwala omwe ali ndi zizindikiro za hyperglycemia - ochepera 6.5 mmol / L.

Amithenga am'magazi a Hormonal amapangidwa mwachilengedwe ndi ziwalo za adrenal ndi ziwalo zoberekera. Amasokoneza chitetezo chathupi ndipo amagwiritsidwa ntchito pochiza matenda otsatirawa a autoimmune,

mphumu
lupus,
nyamakazi
Matenda a Crohn
zilonda zam'mimba.

Kuti akwaniritse cholinga chawo, corticosteroids amatengera zotsatira za cortisol, timadzi timene timatulutsa impso, mwakutero timatsogolera pamavuto chifukwa cha kuthamanga kwa magazi ndi shuga.

Komabe, palimodzi ndi phindu, zinthu zopangidwa zogwira ntchito zimakhala ndi zotsatira zoyipa, mwachitsanzo, kunenepa kwambiri ndi kuwonda kwa mafupa mukamatengedwa nthawi yayitali. Odwala a Corticosteroid atengeka mosavuta ndi chitukuko cha dziko lotengeka.

Pakukhudzidwa kwambiri kwa m'magazi, maselo opanga insulin amatulutsa timadzi tambiri kuti timatseke shuga. Chifukwa chake, umasiyanitsa shuga mkati mwa yokhazikika kuti thupi lonse lizigwira ntchito.

Kuletsa zochita za insulin.
Wonjezerani shuga.
Kupanga kwamphamvu kwa chiwindi.

Zinthu zophatikizika zomwe zimagwiritsidwa ntchito pochiza mphumu sizimakhudza shuga. Komabe, mulingo wake umakwera m'masiku ochepa ndipo udzasiyanasiyana kutengera nthawi, mlingo ndi mtundu wa mahomoni:

Zotsatira zamankhwala akumamwa zimathera patatha maola 48 mutachotsedwa,
Zotsatira za jakisoni zimatha masiku atatu mpaka 10.

Atayimitsa kugwiritsa ntchito ma steroid, glycemia imayamba kuchepa, komabe, anthu ena amatha kudwala matenda amtundu wa 2, omwe amayenera kuthandizidwa pa moyo wonse. Matendawa amtundu wamtunduwu amakula ndikugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali (oposa miyezi 3).

Zotsatira za chiopsezo cha odwala omwe akuphatikizidwa zimaphatikizapo zomwe zimayambitsa kukula kwa matenda a 2th degree:

mkulu index misa
mbiri ya banja
kupezeka kwa mawonekedwe a matenda.
polycystic ovary syndrome,
zaka zopitilira 40.

Nthawi zambiri, odwala omwe amadwala matenda a shuga a steroid alibe zizindikiro zoyambirira.

Kwa iwo omwe amatenga corticosteroids pafupipafupi, Zizindikiro zimayamba pang'onopang'ono ndikuphatikizira:

kamwa yowuma
maso osalala
ludzu lochulukirapo
kusowa kwamadzi
kukodza pafupipafupi chifukwa cha kulephera kwa impso kusefa glucose onse mkodzo,
kutopa ndi mphwayi.

Monga mitundu yonse ya matenda amtunduwu, njira zoyambira kukonza glycemic kuphatikizira ndi kusintha kwa moyo. Chithandizo cha matenda chodalira insulini chimadalira kuchuluka kwa insulini komanso kuchuluka kwa shuga m'magazi. Zitha kukhala zakudya komanso masewera olimbitsa thupi, koma mungafunike mankhwala othandizira odwala matenda ashuga kapena mahomoni opanga.

Zakudya za anthu odwala matenda ashuga ndizakudya zopatsa mphamvu zamagetsi. Zoyenera, ziyenera kutsimikiziridwa payekha kwa wodwala aliyense, kutengera:

Zakudya za anthu odwala matenda ashuga zimakhudza zofunika pazakudya, mavitamini ndi michere. Chakudya chizikhala chokhazikika 4-5 pa tsiku. Maziko ake ndi zakudya zama calorie otsika komanso mankhwala osokoneza bongo omwe amachepetsa glycemia.

Oral hypoglycemic wothandizira kapena wopanga yogwira mankhwala amalembedwa ndi dokotala, chifukwa cha zovuta za insulin komanso kuphwanya kwapanja insulin.

Zizindikiro ndi kupewa matenda ashuga:

Mankhwala a Steroid pakuwongolera zamomwe timakhala ndi zotsatirazi:

Kuyang'anira kuchuluka kwa shuga m'magazi.
Kuchita masewera olimbitsa thupi pafupipafupi.
Kudya wathanzi
Zakudya zopatsa thanzi zophatikiza.
Zithandizo zapakhomo.

Popeza chithandizo cha matendawa ndizovuta kwambiri, ndikofunikira kutenga corticosteroids onse omwe adalembedwa ndi adokotala pokhapokha akutsatira malangizowo. Musasiye kumwa mankhwalawa mwadzidzidzi, chifukwa izi zitha kuwonjezera mwayi wokhala ndi matenda a shuga a steroid.

Dongosolo la portal sikuti limalimbikitsa kuti mudzipangire nokha ndipo, pazizindikiro zoyambirira za matendawo, limakulangizani kuti mukaonane ndi dokotala. Tsamba lathu lili ndi madokotala aluso kwambiri, omwe mungapange nthawi yokumana pa intaneti kapena pafoni. Mutha kusankha dokotala woyenera kapena mutha kukusankhirani zaulere. Komanso pokhapokha pojambula kudzera mwa ife, Mtengo wakufunsira udzakhala wotsika kuposa chipatala chokha. Izi ndi mphatso yathu yaying'ono kwa alendo athu. Khalani athanzi!

Matenda a shuga a Steroid: kuzindikira, zizindikiro ndi chithandizo

Matenda a shuga amayamba kudutsa fomu yachiwiri ya steroid, pomwe wodwalayo sangachite popanda insulini. Zizindikiro zimatha kusiyanasiyana ndi matenda omwe amayambitsidwa. Kuchita mopitirira muyeso, kufooka, komanso thanzi labwino kumawonedwa. Timaganizira mwatsatanetsatane m'nkhaniyi.

Steroid matenda a shuga ndi mtundu wa matenda a shuga omwe ali ndi mawonekedwe achiwiri. Matenda amapezeka pamene ntchito ya impso imalephera, ndipo mahomoni a adrenal cortex amasungidwa kwambiri. Matenda a shuga amtunduwu amayamba chifukwa cha kugwiritsa ntchito nthawi yayitali mankhwala a mahomoni.

Mankhwala a shuga a Steroid

Mankhwala a Hormonal omwe amadziwika kuti amathandizira odwala matenda ashuga amathandizanso kuvutikira kwa metabolic, makamaka kuphatikiza mapuloteni. Mankhwala Ofunika - iyi ndi Prednisolone, Dexamethasone, yokhudzana ndi gulu la mahomoni, komanso Hypothiazide, Navidrex, Dichlothiazide - awa ndi okodzetsa.

Kugwiritsa ntchito mankhwalawa kumathandizira odwala omwe ali ndi matenda osokoneza bongo omwe ali mu mawonekedwe oyamba kukhalabe ndi shuga m'magazi komanso amachotsa madzi owonjezera mthupi. Nthawi yomweyo, kugwiritsa ntchito kwawo nthawi yayitali kumatha kuyambitsa mawonekedwe achiwiri - matenda a shuga. Poterepa, wodwalayo sangathe popanda insulin. Pangozi ndi anthu onenepa kwambiri, komanso othamanga omwe amagwiritsa ntchito mankhwala a steroid kuti achulukitse minofu.

Pali mankhwala ena omwe amathandizira kuti pakhale shuga yachiwiri: kulera, mankhwala okodzetsa ndi mankhwala omwe amaperekedwa chifukwa cha mphumu, kuthamanga kwa magazi ndi arthrosis.

Mukamapereka mankhwala a mahomoni, muyenera kukhala akhama pantchito kuti mupewe kuchitika kwambiri. Chithandizo chiyenera kuyang'aniridwa mosamala ndi adokotala.

Matenda a shuga atangolowa mu mawonekedwe a steroid, wodwalayo amayamba kumva kufooka kwambiri, kugwira ntchito mopitirira muyeso komanso osadutsa wathanzi. ZizindikiroKhalidwe lakale la shuga - ludzu losatha ndi kununkhira kwa acetone kuchokera mkamwa - ndizofooka kwambiri. Choopsa ndichakuti Zizindikiro zotere zimatha kudwala matenda aliwonse. Chifukwa chake, ngati wodwalayo sapangana ndi dokotala munthawi yake, matendawa amasintha kukhala mtundu waukulu wa matenda a shuga a steroid, omwe amaphatikizidwa ndi pafupipafupi. Kufunika kwa insulin kukukulira.

Ngati matenda a shuga a steroid amapezeka pa chithandizo cha matenda monga mphumu, matenda oopsa, arthrosis ndi ena, wodwalayo amamva pakamwa pouma, kukoka pafupipafupi, kuwonda kwambiri.

Nthawi zina, abambo amayamba kukhala ndi mavuto azikhalidwe zakugonana, mwa akazi - matenda opatsirana mwa ziwalo zoberekera.

Odwala ena ali ndi vuto lodana ndi masomphenya, kumva kuwawa ndi kutalika kwa miyendo, kumverera kwachilendo kwanjala.

Ngati mukumva kufooka kosalekeza komanso kutopa msanga, ndibwino kumayeseza mkodzo ndikuwunika magazi. Monga lamulo, mulingo wa glucose mwa iwo ndi kuyambika kwa matenda ashuga yachiwiri umachuluka kwambiri ndipo umapitilira miyambo yovomerezeka.

Chifukwa chakuti zizindikiro za matenda a shuga a steroid ndi ofanana ndi zizindikiro za matenda ena aliwonse, zimatha kupezeka ndi zotsatira za kuyesa kwamkodzo ndi magazi a shuga. Ngati shuga mkati mwawo amaposa 11 mmol, ndiye kuti iyi ndi njira yachiwiri ya matenda ashuga.

Kuphatikiza apo, endocrinologist amasankha kuyesa impso ndi adrenal glands. Chowonadi cha kumwa mankhwala a mahomoni ndi diuretic chimawerengedwa.

Kutengera zinthu izi, chithandizo chamankhwala chimayikidwa kuti chichepetse shuga komanso kuchepetsa matenda a impso.

Mankhwala amatengera zovuta za matendawa. M'masiku oyambilira, wodwalayo amatha kudwala zakudya zoyenera komanso mankhwala. M'malo osasamalidwa, kuchitapo kanthu kwa opaleshoni kumafunika.

Njira zazikulu zochizira matenda a shuga a steroid:

Kuthana ndi mankhwala omwe amakhumudwitsa kupezeka kwa matendawa.
Chakudya cholimba. Wodwala amangodya zakudya zamagulu ochepa.
Kusintha ntchito za kapamba ndikukhazikika m'magazi a shuga, ma jakisoni a insulin ndi omwe amapatsidwa (onani komanso momwe angabayire insulin molondola).
Mankhwala ena omwe amachepetsa shuga amathandizidwanso.

Insulin imayikidwa pokhapokha ngati mankhwala ena sangapereke zofunika pakukhazikitsa shuga. Kumwa jakisoni kumalepheretsa zovuta za matenda a shuga a steroid.

Nthawi zina, wodwala amafunikira opaleshoni. Opaleshoniyo akhoza kukhala ndi cholinga chochotsa adrenal cortex kapena minyewa yambiri, ma neoplasms osiyanasiyana. Nthawi zina ma tezi a adrenal amachotsedwa kwathunthu. Kuchita koteroko kumatha kuchepetsa matendawa, ndipo nthawi zina msuzi wa shuga umabwezeretsedwa.

Koma pali zovuta. Pambuyo pakuchita opaleshoni, njira za metabolic m'thupi zimaphwanyidwa, ntchito ya impso imabwezeretsedwa kwa nthawi yayitali. Zonsezi zimatha kuyambitsa zovuta zingapo mthupi. Motere, kulowererapo kwa opaleshoni kumagwiritsidwa ntchito kawirikawiri.

Pazolinga zopewera, kuti musakhale ndi matenda ashuga a steroid, muyenera kutsatira zakudya zama carb ochepa. Izi ndizowonetsa kwambiri kwa odwala matenda ashuga komanso omwe angatenge odwala.

Ngati mumagwiritsa ntchito mankhwala a mahomoni pochiza matenda ena, muyenera kuchita masewera olimbitsa thupi pafupipafupi. Kupanda kutero, pamakhala chiopsezo cha kuchuluka kwambiri kwa thupi, zomwe zimapangitsa kuchuluka kwa shuga mthupi. Ngati mukumva kutopa kosalekeza, kuchepa kwa ntchito, muyenera kufunsira upangiri wa akatswiri.

Mtundu wa insulin wa matenda a shugaidi umachiritsidwa kwathunthu muzochitika zina. Ndikofunika kumvetsetsa kuti matendawa sakuyenera kuthamanga. Kulumikizana ndi akatswiri panthawi yake kungakuthandizeni kupewa zoyipa. Kudzidziwitsa nokha sikofunika. Chithandizo chake chimatengera zisonyezo ndi machitidwe a thupi.

Michael, shuga ya Weisman: zonse zomwe madotolo sanatchule / Mikhail Weisman. - M: Vector, 2012 .-- 528 c.
Aleshin B.V. Kukula kwa goiter ndi pathogeneis wa matenda a goiter, State Medical Publishing House of the Russian SSR - M., 2016. - 192 p.
Balabolkin M.I. Diabetesology, Mankhwala - M., 2012. - 672 p.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Zizindikiro

M'mayambiriro oyamba a matendawa, kuchuluka kwa corticosteroids kumayambitsa maselo a endocrine kapamba, koma kupanga insulin kukupitirirabe. Uku ndiye kuvuta - matendawa ali kale kale, koma zizindikiro zake ndi zofooka kwambiri ndipo wodwalayo sanachedwe kupita kuchipatala.

Ndi kuyimitsidwa kwathunthu kwa insulini, zizindikiritso za matenda wamba zimawonekera:

Polyuria
Polydipsia
Zofooka
Kutopa,
Zovuta zonse.

Kuchepetsa mwadzidzidzi sikukuchitika kwa odwala matenda ashuga, monganso momwe glycemia amasinthira mwadzidzidzi. Kuchuluka kwa shuga ndi acetone mu madzi amthupi ophunziridwa (magazi ndi mkodzo) nthawi zambiri kumakhala pafupi ndi zabwinobwino. Izi zimapangitsa kuti zikhale zovuta kudziwa bwinobwino.

Zolinga za maonekedwe

Matenda a Steroid amapezeka chifukwa cha kuchuluka kwa corticosteroids m'magazi a anthu. Zomwe zimapangitsa kuti izi zitheke zimatha kukhala zachikhalidwe komanso zamkati.

Ndi amkati am'mimba, kuchuluka kwamahomoni kumatha kuonekera chifukwa cha matenda amtundu wa endocrine. Ndi exo native - kuchuluka mahomoni kumachitika pambuyo ntchito kwa glucocorticosteroid mankhwala.

Wachikunja

Matenda a asteroid angayambitse:

Thiazide diuretics (Ezidrex, Hypothiazide).
Mankhwala omwe amagwiritsidwa ntchito pochiza ziwopsezo zam'mimba, polyarthritis, diphtheria, chibayo, typhoid fever, matenda opatsirana a mononucleosis ndi matenda ena ambiri, kuphatikizapo matenda a autoimmune. Gululi la mankhwalawa limaphatikizapo Betaspan, Dexamethasone, Prednisolone, Dexon, Anaprilin.
Mankhwala oletsa kutupa
Mapiritsi othandizira kubereka

Kuphwanya kwa pituitary England kumawononga mphamvu ya kukokana kwa minofu ndi maselo a thupi kupita ku insulin. Mwa zina zotere, Itsenko-Cushing syndrome nthawi zambiri imakumana, yomwe imadziwika ndi secretion ya mahomoni cortisol ndi adrenal cortex.

Matenda otere nthawi zambiri amawonetsedwa motsutsana ndi matendawa a matenda a Itsenko-Cushing, omwe amasiyana ndi matendawa chifukwa chakuti kuthamanga kwa adrenal cortex kumachitika nthawi yachiwiri.

Choyambitsa chachikulu cha matendawa ndi pituitary microadenoma.

Matenda a Graves (poyizoni goiter), nthenda ya chithokomiro ya autoimmune yomwe mpweya wa insulin umachepa komanso kuchuluka kwa shuga m'magazi kumawonjezeranso, zomwe zingayambitse nawonso matenda a shuga.

Gulu lamavuto

Matenda a shuga a Steroid samapangidwa mwa odwala onse omwe amamwa mankhwala a corticosteroid. Pali zinthu zina zomwe zimawonjezera mwayi wodwala matenda amtunduwu:

Kulemera kwambiri
Kulephera kuchita masewera olimbitsa thupi,
Zakudya zopanda pake.

Kuonjezera thupi, komwe kumatha kuonekanso chifukwa chakuchita zinthu zolimbitsa thupi, kumapangitsa kuti magazi azikhala ndi insulin, lipids, cholesterol, glucose komanso magazi. Ndi kuwonjezeka kwa index yamasamba a thupi, yomwe imawerengedwa pogawa kulemera kwake ndi masentimita kutalika kwamamita, mpaka 27 kg / m2, izi zimabweretsa kuchepa kwa chidwi cha minofu kuti insulin.

Kukula kwa shuga wangwiro, wosavuta wosuta (shuga wamafuta, uchi), mafuta osavuta komanso kuchepa kwa mapuloteni muzakudya kumasokoneza machitidwe a metabolic mthupi, omwe angayambitse kunenepa kwambiri.

Zizindikiro

Chovuta chodziwikiratu kuti matendawa ndiwowonetsa ndikuwonetsa kuti mayesedwe a magazi ndi mkodzo amangoyerekeza pang'ono pokha pokhazikitsidwa. Njira yolondola yozindikira ndi kuyeserera kwa shuga, komwe kumatsimikiza kukhalapo kwa prediabetes.

Kuzindikira kwa matenda a shuga kuchitika kungayambike pakukula kwa shuga wamagazi kuyambira 6 mmol / L pamimba yopanda kanthu mpaka 11 mmol / L atatha kuthira ndi yankho la shuga. Kenako mtundu wake umapezeka.

Kuti mupeze matenda a shuga a steroid, kuyesa kowonjezereka kumachitika: 17-ketosteroids ndi 17-hydroxycorticosteroids mkodzo, kuyezetsa magazi kwa mulingo wamahomoni omwe amapangidwa ndi adrenal cortex, gland pituitary.

Matenda a shuga a Steroid amathandizidwa molingana ndi malamulo omwewo monga mtundu wachiwiri wa shuga ndipo njira zowalipirira ndi zofanana.

Chithandizo chothandiza cha matenda a shuga a steroid ndi motere:

Kuchotsa kwa Corticosteroid,
Makulidwe a insulin
Kudya
Kumwa mankhwala antidiabetes
Kuthandizira opaleshoni.

Ndi exo native chikhalidwe cha chitukuko cha matendawa (kugwiritsa ntchito glucocorticoids), ndikofunikira kuyimitsa makina awo ndikusankha mayendedwe otetezeka. Gawo lotsatira la mankhwalawa ndi zakudya, kugwiritsidwa ntchito kwa othandizira a hypoglycemic ndi mankhwala a insulin.

Ndi endo native hypercorticism, pamene matenda a shuga a steroid amayamba chifukwa cha kusayenda bwino kwa thupi, kuchitapo kanthu opaleshoni nthawi zambiri, komwe kumaphatikizapo kuchotsa minyewa yambiri m'magazi a adrenal.

Kugwiritsa ntchito mankhwala a antidiabetic kuyenera kuphatikizidwa ndi jakisoni wa insulin, apo ayi zotsatira za hypoglycemic za kukhazikitsidwa kwawo sizikhala zochepa kapena sizipezeka kwathunthu. Izi ndichifukwa choti insulini imalola kuti kwakanthawi ichepetse ma cell a beta ndikuwathandiza kuti abwezeretse ntchito zawo zachinsinsi.

Zakudya zamafuta ochepa zimaphatikizapo kuchepetsa kuchuluka kwa chakudya chamafuta tsiku lililonse ndikuwonjezera kudya kwama protein ndi masamba. Chifukwa chotsatira kudya zakudya zotere, thanzi lathunthu limayenda bwino, kufunikira kwa mankhwala osungunulira inshuwaransi ndi shuga kumachepa, ndipo kulumpha kwakuthwa m'magawo a shuga mukatha kudya kumachepetsedwa.

Gulu la mankhwala

Mankhwala ochepetsa shuga amabwera m'magulu angapo:

Kuchokera ku Sulfonylurea,
Khalimakon,
Alfa glucosidase zoletsa
Meglitinides,
Incretinomimetics.

Zotsatira za sulfonylureas nthawi zambiri zimagwiritsidwa ntchito pochiza matenda amishuga a 2, chifukwa cha ichi matenda a shuga. Kapangidwe ka kachitidwe kawo ndikuwonetsa ma cell a B a endocrine gawo la kapamba, chifukwa chomwe kuli kusuntha komanso kuchuluka kwa insulini.

Madokotala omwe amapezekapo amatipatsa mankhwala monga Glycvidon, Chlorpropamide, Maninil, Tolbutamide, Glipizide.

Meglitinides (Nateglinide, Repaglinide) zimawonjezera kupanga kwa insulin komanso kutsika kwa shuga.

Biguanides (Bagomet, Metformin, Siofor, Glucofage) - mankhwala omwe machitidwe awo cholinga chake ndi kuthana ndi kupanga shuga (gluconeogenesis) ndikusintha momwe magwiritsidwe akewo amagwiritsidwira ntchito. Pakakhala jakisoni wa insulin, zotsatira za biguanides sizikuwonetsedwa.

Thiazolidinediones kapena glitazone (Pioglitazone ndi Rosiglitazone) zimawonjezera kukhudzika kwa minofu, minofu ya adipose ndi chiwindi kupita ku insulin, mwa kuyambitsa zolandilira, komanso kukonza lipid metabolism.

Alfa-glucosidase inhibitors (Voglibosis, Glucobai, Miglitol) amachepetsa kuwonongeka kwa saccharides, kuchepetsa mapangidwe ndi mayamwidwe a glucose m'matumbo.

Gulu la acincinomimetics (Liraglutid, Exenatide, Sitagliptin, Saksagliptin) ndi gulu latsopano la antidiabetes, othandizira omwe amagwiritsa ntchito zomwe zimadalira mphamvu za ma insretins, mahomoni otulutsidwa ndimitundu ina yaing'ono yamatumbo atatha kudya. Kudya kwawo kumathandizira kutulutsa kwa insulin, kutsitsa shuga.

Matenda a shuga a steroid amadziwika ndi njira yokhazikika komanso yovomerezeka. Chithandizo cha matenda oterewa chimayenera kukhala chokwanira komanso kuphatikiza jakisoni wa insulin komanso kugwiritsa ntchito mankhwala ochepetsa shuga, komanso zakudya komanso moyo wokangalika.