Kupanga kwa insulin mthupi la munthu kumayendetsedwa ndi kapamba, zisumbu za Langerhans ndizomwe zimapangitsa kuti zinthu izi zitheke. Kutulutsa kwambiri mahomoni m'magazi kukusonyeza kukula kwa matenda omwe amadziwika kuti hyperinsulinism, momwe kuchuluka kwa shuga m'magazi kumatsika kwambiri. Pali matenda a hyperinsulinism mwa ana ndi akulu, ndizovuta kwambiri kulekerera, amathandizidwa kwa nthawi yayitali.

Mkhalidwe wa maphunzirowa umasiyanitsa mtundu wamatenda ndi matenda owopsa. Njira yodwala yamatenda nthawi zambiri imatha ndikutopa, kuchepa kwa malingaliro, kufooka, komanso kupsa mtima. Ntchito ya ziwalo zonse, machitidwe amasokonekera. Kutengera zomwe zidayambitsa matenda, amasiyanitsa:

kapamba (pulayimale), organic hyperinsulinism,
extrapancreatic (sekondale), yogwira hyperinsulinism.

Kukula koyambirira kwa matendawa kumayambitsidwa ndi kupweteka kwa kapamba, kapangidwe kazinthu zina za chinthuchi. Nthawi imeneyo, ngati sekondale limachitika chifukwa cha matenda osachiritsika a chiwalo chilichonse. Matendawa amathanso kukhudza gawo laling'ono la kapamba, kukhala ndi chidwi, kapena kuphimba konse madera omwe amakhala.

Pozindikira mawonekedwe amomwe amapangira matenda, akatswiri tsiku lonse amawunika momwe wodwalayo alili, amatenga magazi ndi mkodzo kuti awunikidwe, kudziwa glycemia yokhala ndi shuga, pangani mayeso a adrenaline, insulin. Kuphatikiza apo, ndi mawonekedwe a organic of pathology, kupangika kwadzidzidzi kwa insulin sikumayendetsedwa ndipo sikakulipiridwa ndi njira zama hypoglycemic. Izi zimachitika chifukwa ntchito ya neuroendocrine system imasokonekera, kuperewera kwa shuga kumapangidwa.

Mtundu uliwonse wamatendawa ndi wowopsa, umafunika kulowererapo mwachangu kwa akatswiri, mwachangu, chithandizo choyenera. Ndizosavuta kupanga matenda popanda dokotala wodziwa bwino komanso wapadera matenda.

Zomwe zimachitika

Matendawa amatha kuchitika mwazaka zilizonse, ngakhale mwa akhanda. Matendawa amtunduwu ndi owopsa, pancreatic hyperinsulinism imachitika pazifukwa zingapo:

Matenda a chapakati mantha dongosolo,
kugonjetsedwa kwa zisumbu za Langerhans ndi chotupa cha zoyipa ndi zoyipa zoyambira,
tumizani hyperplasia (chotupa) cha kapamba,
kukula kwa matenda ashuga
kunenepa
kagayidwe kachakudya
matenda endocrine.

Njira yachiwiri yamatendawa imayambitsidwa ndi matenda a chiwindi, chimbudzi, chikhodzodzo. Izi zimachitika chifukwa cha kusowa kwa shuga m'magazi, omwe amabadwa ndi matenda ena amtundu wa endocrine, matenda a metabolism, matenda a nthawi yayitali, kugwira ntchito molimbika. Komanso kuti zifukwa zonse ndizomveka kapena zochepa, madokotala amayang'ana kwambiri chifukwa chake khansa imayamba chifukwa cha kapamba ndipo sichidziwika bwinobwino. Sizikudziwika bwino zomwe zimabweretsa kugonjetsedwa wamba, pang'ono.

Zizindikiro

Kutengera chifukwa chomwe hyperinsulinism imachitikira, zizindikiro zimatha kukhala zosiyanasiyana. Kuphatikiza pa shuga wochepa, madokotala amatulutsa:

mutu
kutopa kosalekeza
kufooka
kugona
womvera
general malaise
njala yosalekeza
miyendo yanjenjemera
kuchuluka kukwiya
kukomoka
kukokana
kuchepetsedwa kwa mavuto
kutuluka thukuta kwambiri
kutsitsa kutentha kwa thupi
kukomoka mtima,
kumverera kwa mantha
mavuto
dziko lokhumudwitsa.

Kutengera mtundu wa matendawa, mwachitsanzo, ndi hyperinsulinism yogwira ntchito, zizindikirazo zitha kukhala zochulukirapo. Munthawi zonsezi, zizindikiro zina zimakhala zapamwamba kuposa zina kapena zimadutsa limodzi. Hyperinsulinism mwa ana sikuwoneka ngati yotamandika, koma mulimonsemo momwe zimonekera, zimafunikira kuwunika komanso kuthandizira, matenda amtunduwo amayamba kuwonjezeka, ndikupangitsa kuti pakhale zambiri. Chifukwa chake, mukayamba matendawa, ndiye kuti posachedwa zizindikiro zake zidzatchulika kotero kuti mkhalidwe wamtundu wa chipatala ndiwotheka.

Mankhwala amakono amagwiritsa ntchito mawu akuti congenital hyperinsulinism, ndipo matenda amapezeka mwa akhanda ndi makanda. Zomwe zimayambitsa matendawa sizimadziwika, chifukwa chake madokotala amati kubadwa mwatsopano, vuto la majini limakhudzanso. Fomuyi imatchedwanso idiopathic hyperinsulinism, zizindikiro zake sizitchulidwanso kwambiri.

Momwe mungaperekere thandizo loyamba

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

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

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

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

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

Kupewa

Akatswiri odziwa ntchito masiku ano amati masiku ano, njira zopeweka kuyambika ndi kukula kwa maselo a zotupa pa kapamba sizikudziwika. Komabe, amalangizidwa kuti muzisamalira thupi lanu lonse, kupewa zomwe zimachitika:

kusuntha mwachangu
idyani pomwe, osadya kwambiri,
khalani ndi moyo wabwino
pewani kusokonezeka m'malingaliro,
Kuchulukana kwakuthupi komanso kwakuthupi sikuyenera kuloledwa,
Osagwiritsa ntchito mankhwala omwe amathandiza kutsitsa shuga wamagazi popanda malangizo oyenerera a dokotala.

Ngati sizotheka kupewa matendawa, makamaka zikafika kwa akhanda omwe akudwala matendawa, muyenera kulankhulana ndi chipatala mwachangu. Tsatirani zonse zofunikira ndi malingaliro a akatswiri, kuvomereza njira zochiritsidwira. Mwanjira imeneyi, chithandizo cha hyperinsulinism chitha kukhala chothandiza ndikuyambiranso kuthana mtsogolo. Tiyenera kukumbukira kuti, malinga ndi ziwerengero, 10% ya odwala oterewa amafa chifukwa chofunafuna thandizo la akatswiri, kunyalanyaza zam'mawu, komanso kukana panthawi ya chithandizo.

Matenda ambiri osachiritsika nthawi zambiri amakhala isanayambike matenda ashuga.

Mwachitsanzo, hyperinsulinemia mwa ana ndi akulu imapezeka kawirikawiri, koma ikuwonetsa kupanga kwa mahomoni ambiri omwe angapangitse kuchepa kwa shuga, kusowa kwa mpweya ndi kuperewera kwa dongosolo lonse lamkati. Kuperewera kwa njira zochizira zomwe cholinga chake kupondereza kupanga insulin zingayambitse kukula kwa matenda osokoneza bongo.

Zoyambitsa matenda

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

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

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

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

Zinthu zazikulu zomwe zingayambitse kuchuluka kwa mahomoni:

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

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

Magulu owopsa

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

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

Zizindikiro za Hyperinsulinism

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

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

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

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

Mawonekedwe a hyperinsulism kwenikweni samasiyana mwa ana ndi akulu. Chimodzi mwa zomwe matendawa amadwala ndikuwonjezera kukomoka komwe kumayambira kumbuyo kwa glycemia, komanso kuthamanga kwawo komwe kumachitika mobwerezabwereza. Zotsatira zakuchulukirachulukira komanso kupumula kwanthawi zonse zoterezi ndi mankhwala osokoneza bongo ndikuphwanya thanzi la m'mutu mwa ana.

Kodi matendawa ndi oopsa bwanji?

Matenda amtundu uliwonse angayambitse zovuta ngati palibe chochitika munthawi yake. Hyperinsulinemia sikuti ndi yosiyana, motero, imayendetsedwa ndi zotsatira zowopsa. Matendawa amatuluka pachimake komanso matenda osachiritsika. Kuphunzira kumene kumapangitsa kuti zinthu za mu ubongo ziwonongeke, zomwe zimakhudza gawo la psychosomatic.

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

Hyperinsulinemia yomwe imachitika paubwana imakhudza kukula kwa mwana.

Zizindikiro

Nthawi zambiri zimakhala zovuta kudziwa matendawa chifukwa chosapezeka mwatsatanetsatane.

Ngati vuto la kupezeka bwino lapezeka, kufunsa kwa dokotala ndikofunikira, komwe kungadziwe komwe kumayambira pogwiritsa ntchito mayeso otsatirawa:

kusanthula kwa mahomoni opangidwa ndi pituitary gland ndi kapamba,
Pituitary MRI yotsutsa oncology,
Ultrasound yam'mimba
kukakamizidwa
kuyang'ana glycemia.

Kuzindikira kumakhazikika pakuwunika kwa zotsatira za mayeso ndi zodandaula za wodwala.

Kuchiza matenda

Mankhwalawa amatengera machitidwe a matendawa, motero, amasiyananso nthawi yanthawi yochulukitsa komanso kuchotsedwa. Poletsa kuukira, kugwiritsa ntchito mankhwala kumafunika, ndipo nthawi yonseyo ndikukwanira kutsatira kadyedwe ndikuchiza matenda obwera chifukwa cha matenda ashuga.

Thandizo lakuonjezera:

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

Odwala omwe ali ndi vuto lalikulu amayenera kupita kuchipatala ndi kulandira chithandizo moyang'aniridwa ndi madokotala. Ndi zotupa zokhala ndi chithokomiro, zotulutsa ndi zina zofunikira zingafunike.

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

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

Kanema kuchokera kwa katswiri:

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

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

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

Hyperinsulinism ndi matenda omwe amalumikizidwa ndi kuchuluka kwa insulin komanso kuchepa kwa shuga m'magazi. Zizindikiro za matendawa: kufooka, chizungulire, kuchuluka kwa chidwi, kunjenjemera ndi psychomotor. Mawonekedwe obadwa nawo ndi osowa kwambiri, mwa munthu mmodzi mwa ana 50 miliyoni obadwa kumene. Nthawi zambiri, omwe amatenga matendawa amatsimikizika mwa akazi azaka 35-50 zaka.

Hyperinsulinism imazindikirika pakuwunika kwa wodwala, pomwe zowonetsa zamatenda zimawululidwa, pambuyo pake kuyesedwa kwantchito kumachitika, kukhathamiritsa kwa shuga m'magazi kumayesedwa mu mphamvu, ultrasound kapena tomography ya kapamba, ubongo umachitidwa.

Mapangidwe a pancreatic amatha kuthandizidwa kokha. Ndi psychology ya extrapancreatic, chithandizo chamankhwala ndicholinga chothetsa matenda oyambitsidwa ndi mawonekedwe awowo. Wodwala amapatsidwa zakudya zapadera.

Ngati chithandizo cha panthawi yake sichikupezeka, wodwalayo amatha kudwala matenda okomoka.

Congenital hyperinsulinism mwa ana ndi osowa. Zomwe zimayambitsa anomatic ndi:

matenda osiyanasiyana pokonzekera fetal,
masinthidwe amtundu
asphyxia wobadwa.

Matendawa omwe adapezeka ali ndi mitundu iwiri:

Pancreatic Zimatitsogolera ku Mtheradi.
Zosasokoneza. Zimayambitsa kuwonjezeka pang'ono kwa insulin.

Zosiyasiyana zoyambirira zimachitika chifukwa cha kukula kwa chotupa kapena chotupa chowopsa.

Zinthu zotsatirazi zimapangitsa kuti pakhale mawonekedwe osakanikirana:

kuphwanya zakudya, kusala kudya kwanthawi yayitali, kuchepa kwamadzi ambiri chifukwa cha m'mimba, kusanza kapena mkaka
zovuta zamagazi pakugwira ntchito kwa chiwindi (,) zimabweretsa mavuto mu metabolism m'thupi,
Kugwiritsa ntchito molakwika mankhwala osintha shuga m'magazi,
matenda a endocrine
kusowa kwa michere yomwe imakhudza kagayidwe kazakudya.

Kuzindikira kwa hyperinsulinism kumakhudzana ndi shuga. Glucose ndiye michere yofunika kwambiri yamkati yamanjenje, imatenga ubongo kuti ugwire ntchito moyenera. Ngati mulingo wa insulin m'magazi ukakwera ndipo glycogen imadziunjikira m'chiwindi, zoletsa njira ya glycogenolysis, izi zimapangitsa kuchepa kwa glucose.

Kutsika kwa shuga m'magazi kumapangitsa kuti kagayidwe kachakudya kazigwira, kuchepetsa mphamvu yama cell aubongo. Njira za redox zimasokonekera ndipo kuperewera kwa okosijeni m'maselo kumachepa, kuyambitsa kutopa, kugona, kuchepetsa zomwe zimachitika ndikupangitsa. Mukuchulukitsa zizindikirazo, matendawa amatha kupweteketsa mtima, komanso.

Gulu

Congenital hyperinsulinism kuchokera pakuwonekera kwa maphunzirowo atha kugawidwa m'mitundu iyi:

Fomu yochepa. Amapezeka mwa ana obadwa kwa amayi omwe ali ndi matenda osokoneza bongo a shuga.
Fomu yokhazikika. Mtunduwu umapezeka mwa akhanda. Mawonekedwe a pathology amagwirizanitsidwa ndi kubadwa kwatsopano kwa maselo am'malamulo a insulin ndi kumasulidwa kwake kosalamulirika.

Matenda omwe akupitiliza matendawa atha kugawidwa m'magulu awa:

Mtundu wamafayilo. Ili ndi mitundu inayi yomwe imagawidwa molingana ndi mtundu wa cholowa komanso wolowa mosalekeza.
Mtundu wamafuta. Mwachizolowezi, kuchepa kwamphamvu kwa michere ndi ma hyperplasia a gawo limodzi lokhala ndi zida zobayira. Kusintha kwadzidzidzi kwapezeka.
Mtundu wamagulu. Amawonetsedwa ndi zizindikiritso zopanda matenda.

Gulu logwiritsidwa ntchito nthawi zambiri, lomwe limatengera zomwe zimayambitsa matendawa:

Choyamba - kapamba, organic kapena mwamtheradi hyperinsulinism. Zotsatira za chotupa. Mu 90% ya milandu, insulini imalumpha chifukwa cha zotupa zam'mimba ndipo nthawi zambiri imakhala yosavulaza (carcinoma). Mitundu ina yamatenda ndi yovuta kwambiri.
Yachiwiri - yogwira hyperinsulinism (wachibale kapena extrapancreatic). Mawonekedwe ake amaphatikizidwa ndi kuchepa kwa mahomoni a contra-mahormone, ma pathological mu dongosolo lamanjenje ndi chiwindi. Vuto la hypoglycemia limachitika chifukwa cha njala, mankhwala osokoneza bongo omwe amakhala ndi zotsekemera, komanso masewera olimbitsa thupi mopambanitsa.

Tanthauzo la mitundu ndi mawonekedwe a matendawa amachitika pakagwiritsidwa ntchito pozindikira.

Mavuto omwe angakhalepo

Hyperinsulinism imatha kubweretsa zovuta zazikulu komanso zosasinthika zomwe sizigwirizana ndi moyo wa wodwalayo.

Zovuta zazikulu za matendawa:

vuto la mtima
chikomokere
mavuto amakumbukidwe ndi kuyankhula,

Izi zimatengera kudwala kwamatenda komanso zomwe zimachitika. Ngati chotupa chowoneka chikupezeka, makulidwe amachotsedwa, ndipo wodwalayo amachira milandu 90%. Ndi kuvulala kwa neoplasm komanso kulephera kugwira ntchito, kuchuluka kwa kupulumuka kumakhala kotsika.

Hyperinsulinemia ndi chithandizo chake. Hyperinsulinemia: Zizindikiro ndi chithandizo

Hyperinsulinemia ndi njira ya m'magazi momwe kuwonjezeka kwamankhwala a insulin kumawerengedwa. Izi zitha kukhala chifukwa cha zolakwika za receptor, mapangidwe olakwika a insulin, komanso mayendedwe a shuga. Kuti mupeze matendawa, maphunziro a mahomoni, ultrasound, CT, MRI amagwiritsidwa ntchito. Mankhwalawa amayenera kuteteza kulemera kwa thupi mwakuchita masewera olimbitsa thupi, zakudya, komanso mankhwala.

Zakutsogolo

Kuchepa kwa kuchuluka kwa insulin kumawonjezeka mwa anthu:

Ndi cholowa chamtsogolo. Zapezeka kuti anthu omwe ali ndi HLA antijeni amatha kukhala hyperinsulinulin. Komanso, mwayi waukulu wodwala ngati abale anu apamtima amadwala matenda ashuga.
Ndi kuphwanya kwa malamulo apakati pa njala ndi satiety.
Mkazi wamkazi.
Ndi zolimbitsa thupi.
Ndi kukhalapo kwa zizolowezi zoipa (kusuta, kumwa).
Ukalamba.
Zambiri. Adipose minofu ndi gawo lodziyimira endocrine. Imapanga zinthu zosiyanasiyana zogwira ntchito ndipo ndi gawo lamahomoni. Kukhalapo kwa mafuta owonjezera thupi kumabweretsa kusatetezeka kwawo ku zotsatira za insulin. Chifukwa cha izi, kupanga kwake kumawonjezeka.
Ndi kukhalapo kwa atherosulinosis. Zimayambitsa matenda a mtima, kuwonongeka kwa ubongo, matenda amitsempha yama m'munsi.
Mu nthawi ya kusamba.
Ndi polycystic ovary syndrome.
Ndi ochepa matenda oopsa.
Nthawi zonse amatenga mahomoni, thiazide diuretics, beta-blockers.

Zonsezi pamwambapa zimakhudza kufalitsa kwa ma cell mumaselo. Zifukwa zina zitatu zowonjezera kuchuluka kwa insulin ndizosowa.

Zotheka

Matenda a shuga.
Kunenepa kwambiri
Hypoglycemic chikomokere.
Chiwopsezo cha kuwonongeka kwa mtima ndi mitsempha yamagazi chikuwonjezeka.

M'magawo oyamba, hyperinsulinemia siziwonetsa. M'tsogolomu, madandaulo oterewa amawonekera:

kuchuluka kwa mafuta pamimba ndi pamimba,
kuthamanga kwa magazi
ludzu
kupweteka kwa minofu
chizungulire
zosokoneza
kufooka, ulesi.

Hypersecretion ya insulin ikhoza kukhala yogwirizana ndi majini kapena matenda osowa. Kenako zizindikiro zotsatirazi zimawonekera: kusawona bwino, khungu ndi khungu lowuma, maonekedwe a matambalala a pamimba ndi m'chiuno, kudzimbidwa, kupweteka kwa mafupa.

Njira zochizira

Chofunikira kwambiri pa mankhwalawa ndi zakudya. Cholinga chake ndikuchepetsa thupi. Kutengera mtundu wa ntchito (yam'maganizo kapena yakuthupi), zopatsa mphamvu zama calorie zimachepetsedwa kangapo. Kuchepetsa zamankhwala mu chakudya. Amasinthidwa ndi zipatso ndi ndiwo zamasamba. Onjezerani zolimbitsa thupi tsiku lonse. Kudya kumayenera kuchitika maola anayi aliwonse pang'ono.

Kuwonjezeka kwa zolimbitsa thupi kumalimbikitsidwa chifukwa choyenda, kusambira, aerobics, yoga. Mitundu yamphamvu yokhazikika imatha kukulitsa vutoli ndikupangitsa vuto lalikulu kwambiri. Mphamvu yamaphunziro iyenera kukula pang'onopang'ono. Kumbukirani kuti kudya zokha ndi masewera olimbitsa thupi zomwe zingayambitse kusintha.

Pali mawonekedwe a mankhwalawa a hyperinsulinemia ali mwana. Popeza thupi lomwe limakula limafunikira michere kuti likule, chakudya sicholimba. Zakudyazo zimaphatikizapo maofesi a multivitamin ndi zinthu zina (calcium, iron).

Chithandizo cha mankhwalawa chimaphatikizapo mankhwala ogwiritsira ntchito nthawi yayitali:

Othandizira a Hypoglycemic omwe ali ndi milingo yambiri ya shuga (biguanides, thiazolidines).
Ma antihypertensives omwe amateteza kuthamanga kwa magazi komanso kuchepetsa chiopsezo cha zovuta (kugunda kwa mtima, kugunda kwa mtima). Magulu ophatikizidwa a mankhwala: ACE inhibitors, sartans, othandizira calcium. Cholinga cha chithandizo chamankhwala ndikuchepetsa kupanikizika kwa systolic pansi pa 130 mmHg, ndi kukakamiza kwa diastolic pansi pa 80 mmHg.
Kutsitsa cholesterol - ma statins, ma fiber.
Mankhwala ochepetsa chidwi ndi serotonin reuptake inhibitors, zotumphukira za m'mimba zomwe zimaphwanya mafuta.
Metabolic - alpha lipoic acid, yomwe imasintha magwiritsidwe ntchito a shuga ndikuchotsa cholesterol yowonjezera.

Kodi matenda oopsa otani?

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

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

Zoyambitsa Hyperinsulinism

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

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

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

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

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

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

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

Pamene zida zakale zaubongo zimakhudzidwa ndi njira ya pathological (medulla oblongata ndi midbrain, Varolius Bridge) malo olimbikitsa, diplopia, komanso kusokonezeka kwa kupuma ndi mtima kumakula.

Hyperinsulinism

Hyperinsulinism imadziwika ndi kuchepa kwa shuga m'magazi chifukwa chakuwonjezera kwathunthu kapena wachibale pakubisalira kwa insulin. Matendawa amawonekera nthawi zambiri azaka zapakati pa 40 ndi 50. Odwala amakhala ndi vuto la njala, kusowa chidwi, chizungulire, mutu, kugona, tachycardia, kunjenjemera miyendo ndi thupi lonse, kukula kwa ziwiya zotumphukira, thukuta, komanso kusokonezeka kwa malingaliro.

Kuukira kwa hypoglycemia kumayamba chifukwa cholimbitsa thupi kwambiri kapena kumatha kudya nthawi yayitali. Kuphatikiza apo, zinthu zomwe zatchulidwa pamwambazi zimakulirakulira, kusintha kwamanjenje, kuperewera, kukokana, kugona kwambiri, ndipo pamapeto pake, chikomokere chomwe chitha kupha munthu ngati wodwalayo sanalowe shuga m'mitsempha nthawi yayitali. Pankhaniyi, glycemia amachepetsa mpaka 60-20 ndi ochepera shuga% mg.

Nthawi zambiri odwala amawonedwa ndikuchiritsidwa ndi akatswiri azamisala. Matendawa amadziwika ndi Whipple triad. Ndi matendawa, kulemera kwa odwala kumawonjezeka chifukwa cha kudya kosalekeza.

Kusiyanitsa pakati pa organic and functional hyperinsulinism. Choyambitsa chachikulu cha hyperinsulinism ndi benign islet adenoma. Chotupa chikhoza kupezeka kunja kwa kapamba. Khansa ya zisumbu za Langerhans ndizofala. Hyperplasia ya zida zobayikirana imatha kutsagana ndi kuchuluka kwa katemera wa insulin.

Nthawi yomweyo, hyperinsulinism imatha kuchitika popanda zotupa zakanyumba. Fomuyi imatchedwa functional hyperinsulinism. Mwina zimachitika chifukwa kudya zakudya zamafuta ochulukitsa kumakwiyitsa mitsempha ya vagus ndikuwonjezera katemera wa insulin.

Hyperinsulinism imatha kupangidwanso ndi matenda ena amanjenje yapakati, ndi chiwindi chogwira ntchito, kuchepa kwa mphamvu kwa matenda a adrenal, chakudya chamafuta ochepa, muzochitika za kuchepa kwa chakudya chamthupi, kapamba, pancreatitis.

Kuti musiyanitse pakati pa mitundu yodwala ndi yogwira matendawa, glycemia imapangidwanso masana limodzi ndi shuga komanso insulin ndi adrenaline mayeso. Organic hyperinsulinism imayamba chifukwa cha kupanga insulin mwadzidzidzi komanso kosakwanira, komwe sikimalipiridwa ndi maulamuliro a hypoglycemic.

Ntchito hyperinsulinism imayambitsidwa ndi kukula kwa hyperinsulinism yothandizira chifukwa chosakwanira kupezeka kwa glucose kapena mkhutu wa neuroendocrine hypoglycemic. Nthawi zambiri zimawonedwa m'chipatala cha matenda osiyanasiyana okhala ndi vuto logaya.

Kuphwanya njira zomwe zimayendetsa kagayidwe kazakudya zimatha kupezekanso pokhudzana ndi kulowa kwadzidzidzi kwa glucose m'magazi, monga kugwa kwa hypoglycemic kwa odwala omwe akutsatiridwa ndi chapamimba.

Kukula kwa hypoglycemia ndi hyperinsulinism kumayambira pazizindikiro zochokera ku ubongo wamkati. Mu pathogenesis yazizindikiro izi, kuchepa kwa glycemia, kuwopsa kwa kuchuluka kwa insulin, ubongo ischemia ndi hydremia kumathandizira.

Kuzindikira kwa hyperinsulinism potengera chotupa chamagetsi chamagetsi kumayikidwa pazotsatira zotsatirazi. Odwala ali ndi mbiri ya kukomoka kwambiri chifukwa cha thukuta, kunjenjemera, komanso kusazindikira. Mutha kupeza kulumikizana pakati pa chakudya ndi khunyu zomwe nthawi zambiri zimayamba musanadye chakudya cham'mawa kapena maola 3-4 mutatha kudya.

Mlingo wothamanga wamagazi nthawi zambiri umakhala 70-80 mg%, ndipo pakakhala kuukira umatsikira mpaka 40-20 mg%. Mothandizidwa ndi kudya kwa carbohydrate, kuukira kumatha msanga. Panthawi yopatsirana, mutha kuyambitsa vuto pokhazikitsa dextrose.

Hyperinsulinism chifukwa cha chotupacho iyenera kusiyanitsidwa ndi hypopituitarism, momwe mulibe chakudya, odwala amachepetsa thupi, metabolism yayikulu ili pansi 20%, kuthamanga kwa magazi kumatsika, ndipo chinsinsi cha 17-ketosteroids chimachepa.

Mu matenda a Addison, mosiyana ndi hyperinsulinism, kuchepa thupi, melasma, adynamia, kuchepa kwa zotulutsa za 17-ketosteroids ndi 11-hydroxycysteroids, kuyesa kwa Thorn pambuyo pokonza ma adrenaline kapena adrenocorticotropic timadzi.

Spontaneous hypoglycemia nthawi zina imachitika ndi hypothyroidism, komabe, zizindikiritso za hypothyroidism - mucous edema, kupanda chidwi, kuchepa kwa kagayidwe kake komanso kudzikundikira kwa ayodini wa chithokomiro mu chithokomiro cha chithokomiro, komanso kuchuluka kwa cholesterol yamagazi - kulibe hyperinsulinism.

Ndi matenda a Girke, kuthekera kwokweza glycogen ku chiwindi kumatha. Kuzindikira kumatha kuchitika chifukwa cha kuchuluka kwa chiwindi, kuchepa kwa shuga kumapazi, komanso kusowa kwa chiwopsezo cha shuga ndi potaziyamu m'magazi pambuyo pa adrenaline. Ndi kuphwanya kwa dera la hypothalamic, kunenepa kwambiri, kuchepa kwa ntchito zogonana, komanso kusokonezeka kwa kagayidwe kamchere wamadzi zimadziwika.

Ntchito hyperinsulinism imapezeka ndi kupatula. Mosiyana ndi chotupa chotupa cha m'mimba, kuwopsa kwa ma hyperinsulinism kumachitika mosagwirizana, pafupifupi sikunachitike m'mawa musanadye. Kusala masana nthawi zina sikuyambitsa ngakhale vuto la hypoglycemic. Zovuta zina nthawi zina zimachitika chifukwa cha zomwe takumana nazo m'mutu.

Kupewa kwa hyperinsulinism yogwira ntchito ndikupewa matenda oyambitsidwa, kuletsa kwa chotupa hyperinsulinism sikudziwika.

Chithandizo cha Etiopathogenetic. Ndikulimbikitsidwanso kuti muzidya zakudya zopatsa thanzi monga mapuloteni komanso mapuloteni komanso cortisone, mahomoni a adrenocorticotropic. Ndikofunikira kupewa kuthana kwambiri ndi kuvulala kwam'mutu, ma bromides ndi ma sedatives opepuka. Kugwiritsa ntchito kwa barbiturates kuti shuga m'magazi ali osavomerezeka.

Ndi organic hyperinsulinism, chotupa chomwe chimayambitsa kukula kwa matendawa chikuyenera kuchotsedwa. Pamaso pa opareshoni, malo osungirako mafuta am'mimba amapangidwa ndikupanga zakudya zomwe zimakhala ndi mapuloteni ochulukirapo komanso mapuloteni. Tsiku loti lisanachitike opaleshoni komanso m'mawa asanachitike opaleshoni, 100 mg ya cortisone imalowetsedwa m'matumbo. Pogwira opaleshoni, kulowetsedwa kwa 50% shuga njira yokhala ndi 100 mg ya hydrocortisone imakhazikitsidwa.

Mankhwala osokoneza bongo a organic hyperinsulinism ndi osathandiza. Potulutsa adenomatosis ndi adenocarcinomas okhala ndi metastases, alloxan amagwiritsidwa ntchito pamlingo wa 30-50 mg pa kilogalamu imodzi ya kulemera kwa thupi la wodwalayo. Alloxan yakonzedwa mwa njira ya 50% yothetsera yomwe idakonzedwa panthawi ya kulowetsedwa kwa mtsempha. Njira ya mankhwalawa amagwiritsa ntchito 30-50 g ya mankhwalawa.

Ndi hyperinsulinism yogwira, mahomoni a adrenocorticotropic amagwiritsidwa ntchito pa 40 magawo patsiku, cortisone patsiku loyamba - 100 mg 4 pa tsiku, chachiwiri - 50 mg 4 pa tsiku, ndiye 50 mg patsiku m'magawo anayi ogawanika kwa miyezi iwiri.

Ndi hypoglycemia ya pituitary chikhalidwe, ACTH ndi cortisone amagwiritsidwanso ntchito. Chakudya chomwe chili ndi 400 g yamagulu owonjezera amathandizidwa. Mafuta amakhala ndi nkhawa yokhudza kupanga insulini, yomwe iyenera kukumbukiridwa popanga zakudya.

Chithandizo cha vuto la hypoglycemic imachitika mu 2040 ml ya 40% ya shuga m'mitsempha. Ngati wodwalayo sanazindikire, amayenera kupatsidwa mkamwa pakumwa mphindi 10 zilizonse mpaka mavutowo atha. Ndi mavuto pafupipafupi, ephedrine amatumikiridwa katatu patsiku.

Chithandizo chamakono cha hyperinsulinism

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

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

Tiyenera kukumbukira kuti hypoglycemia imatha kuwonedwa mu zochitika zam'magazi, zomwe nthawi zambiri zimadziwika ndi kuchuluka kwa minofu kupita ku insulin kapena kusakwanira kwa mahomoni olimbana ndi mahomoni.

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

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

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

Mawonetseredwe azachipatala

Hypoglycemia yozama imayambitsa kukhazikika kwa kayendedwe kazigawo zamkati zamanjenje, ma autonomic mantha ndi endocrine machitidwe, omwe amadziwika mu kuphwanya kwa zochita zambiri za ntchito zamagulu ndi ziwalo. Udindo waukulu umayimbidwa ndi vuto la neuropsychiatric ndi chikomokere.

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

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

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

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

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

Chifukwa chofuna kudya pafupipafupi zakudya zamagulu ochulukirapo, odwala amayamba kunenepa ndipo nthawi zambiri amakhala onenepa. Mobwerezabwereza kuchitika kwa hypoglycemia komanso kutalika kwa nthawi yayitali kumatha kubweretsa zovuta zama neuropsychiatric. Odwala otere, mpaka akapezeka ndi insulinomas, nthawi zambiri amathandizidwa ndi akatswiri azamisala.

Hyperinsulinemia ndi chithandizo chake. Zizindikiro ndi hyperinsulinemia (hypoinsulinemia) - chithandizo ndi zakudya

Pakapanda kuthandizidwa panthawi yake, chikomokere chimayamba. Kuzindikira zomwe zimayambitsa vutoli ndizokhazikitsidwa ndi chithunzi cha chipatala, zotsatira za kuyesa koyesa, kuyesa kwamphamvu kwa glucose, ultrasound kapena kusanthula kwamatumbo a pancreas. Chithandizo cha pancreatic neoplasms ndikuchita opareshoni. Ndi mtundu wa extrapancreatic wa matenda, chithandizo cha matenda oyambitsidwa zimachitika, zakudya zapadera zimayikidwa.

Mavuto a Hyperinsulinism

Mavuto amatha kugawidwa kumayambiriro komanso mochedwa. Mavuto oyambilira omwe amachitika patangotha maola ochepa pambuyo poti aukira aphatikize stroke, myocardial infarction chifukwa kuchepa kwambiri kwa kagayidwe kazigawo ka minofu ya mtima ndi ubongo. Pakakhala zovuta, chikomokere cha hypoglycemic chimakula. Pambuyo pake zovuta zimawonekera miyezi yambiri kapena zaka pambuyo poyambitsidwa kwa matendawa ndipo amadziwika ndi vuto la kukumbukira komanso kuyankhula, parkinsonism, encephalopathy. Kuperewera kwa njira yodziwira matendawa ndikuthandizira matendawa kumabweretsa kufooka kwa ntchito ya endocrine ya kapamba ndi kukula kwa matenda a shuga, matenda a metabolic, komanso kunenepa kwambiri. Congenital hyperinsulinism mu 30% ya milandu imabweretsa matenda osokoneza bongo a ubongo komanso kuchepa kwa kukula kwamaganizidwe kwa mwana.

Hyperinsulinism Chithandizo

Njira zamankhwala zimatengera zomwe zimayambitsa hyperinsulinemia. Ndi organic genesis, opaleshoni ya opaleshoni ikuwonetsedwa: kusinthanitsa pang'ono kwa kapamba kapena kapamba konse, kukokomeza kwa neoplasm. Kuchuluka kwa maopareshoni kumatsimikiziridwa ndi malo ndi kukula kwa chotupa. Pambuyo pakuchita opaleshoni, kuchepa kwa mphamvu kwa hyperglycemia nthawi zambiri kumadziwika, kumafuna kuwongolera kuchipatala komanso kudya kokhala ndi zakudya zochepa. Matenda a mtundu wa zizindikiro amapezeka mwezi umodzi atatha kulowererapo. Ndi zotupa zosagwiritsidwa ntchito, mankhwala a palliative amachitika pofuna kupewa hypoglycemia. Mu neoplasms yoyipa, chemotherapy imasonyezedwanso.

Ntchito hyperinsulinism kwenikweni imafunikira chithandizo cha matenda omwe amayambitsa kuchuluka kwa insulin. Odwala onse amapatsidwa zakudya zoyenera komanso kuchepa kwamphamvu kwa chakudya chamagulu (gr. Patsiku lililonse). Zokonda zimaperekedwa ku zovuta zamatumbo (mkate wa rye, supu ya tirigu wa durum, phala lonse la tirigu, mtedza). Chakudya chizikhala chopindika, nthawi 5-6 patsiku. Chifukwa chakuti kuwukira kwakanthawi kumayambitsa kukhazikitsidwa kwa mantha pakati pa odwala, kufunsira kwa katswiri wamalingaliro akulimbikitsidwa. Ndi kukula kwa vuto la hypoglycemic, kugwiritsa ntchito chakudya cham'mimba chotsekemera (tiyi wokoma, maswiti, mkate Woyera) akuwonetsedwa. Popeza simukudziwa, kupangika kwa shuga 40% ndikofunikira. Ndi kupweteka komanso kugwedezeka kwambiri kwa psychomotor, jakisoni wa bata ndi kusinkhidwa akuwonetsedwa. Chithandizo cha matenda oopsa a hyperinsulinism ndi chitukuko cha chikomokerezi chimachitika m'chipinda chosamalitsa cha anthu odwala komanso kulowetsedwa kwa detoxation, kuyambitsa glucocorticoids ndi adrenaline.

Zotsogola ndi kupewa

Kupewera kwa matenda a hypoglycemic kumaphatikiza kudya mokwanira komanso kupatula kwa maola awiri ndi atatu, kumwa madzi okwanira, kusiya zizolowezi zoyipa, ndikuwongolera kuchuluka kwa shuga. Kusamalira ndi kukonza kagayidwe kachakudya mthupi, zolimbitsa thupi zolimbitsa thupi zimalimbikitsidwa potsatira zakudya. Kukula kwa hyperinsulinism kumatengera gawo la matendawa komanso zomwe zimapangitsa insulinemia. Kuchotsa kwa benign neoplasms mu 90% ya milandu kumapereka kuchira. Zotupa zosagwira ndi zopweteka zimayambitsa kusintha kwamitsempha ndipo zimafunikira kuwunika wodwalayo nthawi zonse. Chithandizo cha matenda oyambitsidwa ndi mawonekedwe amachitidwe a hyperinsulinemia kumabweretsa kubwezeretsanso kwa zizindikiro ndi kuchira kwamtsogolo.

Hyperinsulinemia - zizindikiro zazikulu:

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

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

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

Chithunzi chachipatala cha matenda azachipatala awa sichimakhala chachindunji, chifukwa chake, ngati atapezeka mozindikira, dokotala amatha kugwiritsa ntchito njira za kafukufuku komanso zogwiritsira ntchito. Nthawi zina, matenda osiyanasiyana amafunikira.

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

Hyperinsulinemia imatha kukhala chifukwa cha zotsatirazi zotsatsa:

kuchepa kwa chidwi cha insulin receptors kapena kuchuluka kwawo,
kupanga kwambiri kwa insulin chifukwa cha njira zina za thupi.
kusintha kwa shuga m'magazi,
Kulephera posayina mu foni.

Zomwe zimapangitsa kukonzekera kwa njira yotereyi ndi izi:

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

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

Zakudya za hyperinsulinism

Kukhala ndi moyo wathanzi kumathandiza kupewa matenda ambiri, makamaka hyperinsulinism. Kupewa kumaphatikizapo:

chakudya chopatsa thanzi, chopanda zowonjezera, utoto ndi mowa,
kuwunikira nthawi zonse zaumoyo,
kunenepa
masewera a tsiku ndi tsiku
amayenda mumlengalenga.

Ngati pali chizolowezi choyambika kwa matenda ashuga kapena mavuto ena okhudzana ndi njira ya metabolic m'thupi, ndikosavuta kusintha njira ya moyo kuposa kuchitira zotsatira pambuyo pake. Ndikofunika kukumbukira kuti matenda ngati awa samadutsa popanda kufufuza ndipo nthawi zonse amasiya kuyamwa, mwa odwala ena amakhalanso moyo wonse. Potere, chithandizo cha mankhwala osokoneza bongo komanso zoletsa zovuta pazakudya zimaphatikizidwa.

Chidziwitsocho chimaperekedwa kuti chizidziwitso chokha chokha ndipo sichingagwiritsidwe ntchito pakudzipangira nokha mankhwala. Osadzinyengerera, zitha kukhala zowopsa. Nthawi zonse funsani dokotala. Pofuna kukopera mwatsatanetsatane kapena mwatsatanetsatane zinthu zomwe zili pamalowo, kulumikizana kwofunikira kukufunika.

Kukwera kwathunthu kwamankhwala a insulin, kapena hyperinsulinism: Zizindikiro, kuzindikira ndi chithandizo

Hyperinsulinism ndi matenda omwe amapezeka mwa mtundu wa hypoglycemia, omwe ndiwowonjezera pazachilendo kapena kuwonjezeka kwathunthu kwa insulin m'magazi.

Kuchuluka kwa timadzi timeneti kumapangitsa kuchuluka kwa shuga, komwe kumapangitsa kuti shuga achepetse, komanso kumayambitsa kuperewera kwa mpweya waubongo, komwe kumayambitsa vuto la mantha.

Zochitika ndi zizindikiro

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

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

Zizindikiro za Hyperinsulinism zili ndi izi:

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

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

Mtheradi hyperinsulinism imawonetsedwa ndi zizindikiro zotsatirazi:

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

Zovuta ngati izi zimachitika pambuyo poti mwadzidzidzi watha kuzindikira.

Asanayambe kuukira, zizindikiro zotsatirazi zimawonekera:

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

Makanema okhudzana nawo

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

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

Amachotsa zoyambitsa zovuta
Imachepetsa kupanikizika mkati mwa mphindi 10 pambuyo pa kutsata

Etiology ndi pathogenesis

Chofunika kwambiri ndi njira yayikulu ya hyperinsulinism yoyambitsidwa ndi insuloma, yomwe nthawi zambiri imakhala yosakwatira, yosachulukitsa.

Ma insulomas omwe amagwira ntchito mosiyanasiyana amachokera ku ma cell a beta omwe amapangira zida zosiyanasiyana pakukhwima komanso kusiyana. Osowa kwambiri, amapanga kunja kwa kapamba kuchokera ku ma ectopic insular element. Kukula kwa insuloma nthawi zambiri kumayendetsedwa ndi kuwonjezeka kwa kuchepa kwa hyperinsulinism, ngakhale ndikuwonjezeka kwa ntchito yake, mikhalidwe imapangidwa kuti ikhale yolumikizira hypotrophy ndi hypofunction yotsala yaminyewa ina yamkati. Kukula kwa matendawa mosakayikira kumapangitsa kuwonjezeka kwa kufunika kwa thupi kwa ma carbohydrate, popeza momwe kugwiritsidwa ntchito kwa glucose kumachulukira, magwero ake a mapangidwe ake amatha, makamaka, malo ogulitsira a glycogen mu minofu, ndipo hypoglycemia imakulanso, zomwe zimayambitsa kuphwanya ntchito zosiyanasiyana za thupi. Mchitidwe wamanjenje umakhudzidwa makamaka - phylogenetically malo achichepere. Kufunika kwakukulu kwa kuperewera kwa zakudya m'thupi kumapangitsanso kuperewera kwa ubongo ndi kuwonongeka kwa ubongo ndi ziwalo zina zamanjenje zomwe zimawonetsedwa mu maphunziro a histochemical a dongosolo lamanjenje. Kuchepa msanga kwa glycogen osasungidwa muubongo kumabweretsa kusokonezeka kwakukulu pakugwiritsa ntchito mpweya ndi minyewa ya ubongo, yomwe ingayambitse kusintha kosasintha mwa iyo. Mankhwala ambiri obwera chifukwa cha insulin komanso kupweteka kwa nthawi yayitali. Kutuluka kofulumira kuchokera ku kuwukira kwa hypoglycemia kumachitika chifukwa cha njira zowonjezera zomwe, makamaka, ziwalo zobisika za adrenocorticotropic timadzi, corticoids ndi adrenaline zimagwira. Glucogone yotulutsidwa ndi maselo a pancreatic alpha ndi maselo ofanana a m'mimba ndi mucosa wamatumbo, mwachiwonekere, amatenganso nawo mbali pothandizira kubwezeretsa (powonjezera ntchito yawo) ya ozungulira hypoglycemia. Chifukwa chake, ngati chikhazikitso cha insuloma chikufunika mu etiology yamatendawa, ndiye kuti kukulira kwa vuto la hypoglycemic kumakwanira mu chiwembu: gawo loyamba ndikupanga kuchuluka kwa insulin ndi chotupa, chachiwiri ndi kusokonekera kwa dongosolo lamanjenje ndikayamba kwa kukomoka kwa minyewa yaubongo ndi kufooka kwa minyewa yaubongo yokhala ndi glucose ntchito zamanjenje, zomwe zikuwonetsedwa ndi kukhumudwa, komanso kuchepa kwa masitolo a glycogen mu minofu yaubongo - chikomokere.

Chithunzi pamakhalidwe azachipatala

Zizindikiro za Hyperinsulinism, zomwe poyambira kukula kwake sizimawonekera, ndikuphwanya koopsa komwe kumafunika chisamaliro chamankhwala.

Pakusintha kwapang'onopang'ono kwa matenda, mawonekedwe awa ndi mawonekedwe:

kuchuluka kwa mafuta m'thupi lam'mimba komanso pamimba (chithunzi),
mawonetseredwe a khungu lotambalala pakhungu pamafuta,
khungu lowuma, kusintha kwa mawonekedwe,
Zizindikiro za matenda oopsa,
chiwonetsero cha ludzu
kupweteka kwa minofu, kuwonetseredwa popanda ntchito zolimbitsa thupi,
mawonekedwe a chizungulire,
kuchepa kwa chidwi,
kuwonekera kwa kunjenjemera ndi kumverera kwa kuzizira,
Vuto lakusokonekera.

Poyerekeza zakuphwanya kumeneku, thanzi la munthu likuwonongeka msanga, wodwalayo amasankha madandaulo osakonda, ndipo amakhala ofooka komanso oopsa.

Zofunika! Ndi dokotala yekha yemwe angadziwe njira zoyenera kuchitira - kukonza kwakanthawi kadzithandizenso.

Kodi amadziwika bwanji?

Popeza kuchuluka kwa insulin m'magazi sikudutsa popanda kufufuza kachitidwe kambiri ka thupi la munthu, ndikofunikira kugwiritsa ntchito njira yodziwitsa anthu zovuta.

Choyamba, kuyesedwa kwa labotale kukuwonetsedwa, kutanthauza kuperekera mayeso kuti mupeze anthu omwe ali ndende:

Zomwe zaphunziridwazo ndimagazi am'kati mwa wodwalayo, omwe amayenera kuperekedwa mogwirizana ndi algorithm ina. Malangizo okonzekera ayenera kuphunziridwa asanadutse mayeso. Kuphatikiza pa kuyezetsa magazi, kuwunika mayeso a Laborator kumaphatikizapo kuyesa mkodzo - kuyesa kumachitika kuti mupeze mapuloteni mumkodzo wa wodwala.

Yang'anani! Kuyesedwa kwa biochemical magazi kumachitidwanso kuti mudziwe kuchuluka kwa cholesterol yathunthu, komanso LDL ndi HDL. Kuyesaku kumakupatsaninso mwayi kuti muwone kuchuluka kwa glucose m'magazi a wodwala pamimba yopanda kanthu ndikatha kudya.

Kuti muzindikire matenda enieniwo, kuwunika kwa maola 24 kwa wodwala akuwonetsedwanso kumachitika, pogwiritsa ntchito wowunika wa Holter. Dokotala amayenera kuwerengera cholozera mulingo wa thupi - kuyesako kumaphatikizapo kuyerekeza kutalika ndi kulemera kwa wodwala, njira yofananira ndiyosavuta, kuwerengera kungachitike kunyumba, nokha.

Kuti mupeze chithunzi chonse, ndikofunikira kuyeserera kwa ultrasound:

chiwindi
impso
kapamba
ziwalo za m'chiuno mwa akazi - zofunika kupatula matenda azachipatala.

Magnetic resonance imaging sichigwiritsidwa ntchito kawirikawiri, izi ndichifukwa choti mtengo wa kafukufukuyu ndiwokwera kwambiri. Poona kuchuluka kocheperako, kafukufuku wotereyu amangopita pokhapokha ngati pakufunikira chithunzi chazomwe zimagwira, pituitary ndi adrenal cortex. Makamaka, kuyeserera kumachitika ngati pali malingaliro otupa a pituitary.

Njira zopewera

Hyperinsulinemia imatha kupewedwa, chifukwa ndikofunikira kutsatira malamulo osavuta malinga ndi moyo wathanzi:

kutsatira zakudya zomwe zikutanthauza kudya zakudya zopatsa thanzi, kuwunika momwe anthu amadyera,
kupimidwa pafupipafupi, kuphatikiza chopereka chamagazi pakuwunika,
kulimbitsa thupi
kukana kumwa mowa,
kusiya kusuta fodya,
Kuchita masewera olimbitsa thupi pafupipafupi, kumakulolani kuti mukhale ndi thupi labwino.

Ngati mumapeza insulin yayikulu m'magazi, muyenera kufunsa katswiri. Kuchedwa pankhaniyi ndikosavomerezeka, kusamvana sikumakhazikika pazokha.

Mwina mavuto

Ngati vutoli lanyalanyazidwa kwa nthawi yayitali, lingayambitse zovuta zina mwanjira zotsatirazi:

matenda ashuga
kagayidwe kachakudya matenda
kunenepa
hypoglycemic coma,
matenda osiyanasiyana a mtima
zotupa zam'mimba.

Ndikotheka kuti muchepetse kukula kwa hyperinsulinemia, malamulo omwe amapereka prophlaxis ndi ophweka kwambiri ndipo amagwirizana pakukana kudya zamafuta ndi zakudya zotsekemera mopitirira muyeso. Tiyenera kudziwa kuti hyperinsulinemia imangoyambitsa chitukuko cha matenda ashuga, koma kuphwanya kumeneku sikufotokozera zenizeni za matendawa.

Mafunso kwa katswiri

Masana abwino Chaka chatha, endocrinologist anandipeza ndi hyperinsulinism. Munthawi imeneyi, ndinapeza mapaundi owonjezera 15, kulemera kumapitilirabe kukula, ngakhale sindimadya kwambiri. Ndikuopa kwambiri matenda ashuga, ndiuzeni momwe ndichepe thupi ndi matenda anga ndipo zingatheke?

Masana abwino, Victoria. Hyperinsulinism si chiganizo, koma, mwanjira inayake kapena china, chinthu chomwe chimatsimikizira kukula kwa matenda ashuga. Pambuyo pakuzindikira matendawa, vuto lanu liyenera kuyang'aniridwa ndi dokotala.

Kodi katswiri wakuwuzani chiyani za kilogalamu 15 zomwe mwapeza? Kulemera kwanu koyambirira ndi chiyani? Kungowopa matenda a shuga sikokwanira, muyenera kufunsa katswiri m'dera lanu ndikukayang'aniridwa kwathunthu, kukonza zakudya sikokwanira kuthana ndi hyperinsulinemia.

Moni. Anandipeza ndi hyperinsulinemia nditabereka. Iwo adati chifukwa chake ndikukula kwake ndizakudya zopanda thanzi panthawi yomwe muli ndi pakati komanso ndikupeza mofulumira kwambiri, chifukwa kwa miyezi 9 ndidapeza 22 kilogalamu. Kulemera pambuyo pobadwa kwa mwana sikunapite ndipo kukukulira mpaka pano. Kodi ndiyenera kudya zakudya ziti?

Moni Marina. Ndikufuna kuwona zatsatanetsatane kuchokera ku mayeso a labotore omwe amawonetsa kuchuluka kwa insulin m'magazi. Ponena za kadyedwe, nditha kuvomereza Pevzner tebulo No. 9, koma dokotala wanu adzaperekanso malangizo ena atayang'ana zotsatira za mayeso.

Moni. Vutoli silinandidetse nkhawa, koma mwana wanga wamkazi. Zaka ziwiri zapitazo, adabereka mwana. Asanakhale ndi pakati, anali woonda, wovina. Kulemera kwake kunangokhala 52 kg ndikukula kwa masentimita 170. Tsopano kulemera kumafikira 70-73 kg. Anadutsa mayeso, adatenga mapiritsi osiyanasiyana ndi njira zothetsera kuchepa thupi, koma zonse zidapita.

2 kg pa mwezi wakudya amazimiririka, omwe amabwezeretseka. Masiku ochepa okha apitawo ndidapereka magazi pakutsimikiza kwa shuga ndi insulin, shuga ndichabwinobwino, ndipo insulin imakwezedwa - 35. Tidadziyang'ana tokha, chizindikiro ichi chikuwonetsa matenda ashuga a 2nd. Kodi ayenera kuchitanji pamenepa?

Masana abwino Izi si shuga, osadandaula. Pakadali pano, mtengo uwu ukuwonetsa chitukuko cha hyperinsulinism. Kuphonya kotereku ndipo kumalepheretsa mwana wanu wamkazi kusiya kunenepa. M'pofunika kutsogolera mphamvu zonse ku matenda a kagayidwe.

Mtsikanayo atsatire zakudya zomwe adalangizidwa ndi endocrinologist, menyu akuyenera kukambirana ndi wazakudya. Ndibwino kuganizira zolimbitsa thupi. Mankhwala ochepetsa thupi ayenera kusamala, muyenera kusiyanitsa kudya kwawo kosalamulirika.

Kodi kuchuluka kwawonjezereka kapena kuwonjezeka kwathunthu kwamankhwala a insulin m'magazi.

Kuchuluka kwa timadzi timeneti kumapangitsa kuchuluka kwa shuga, komwe kumapangitsa kuti shuga achepetse, komanso kumayambitsa kuperewera kwa mpweya waubongo, komwe kumayambitsa vuto la mantha.

Matendawa amafala kwambiri mwa akazi ndipo amapezeka azaka za 26 mpaka 55. Kuukira kwa hypoglycemia, monga lamulo, kumawonekera m'mawa pambuyo pothamanga mokwanira. Matendawa amatha kugwira ntchito ndipo amadzionetsera nthawi yomweyo, masana.

Zizindikiro za Hyperinsulinism zili ndi izi:

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

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

Mtheradi hyperinsulinism imawonetsedwa ndi zizindikiro zotsatirazi:

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

Zovuta ngati izi zimachitika pambuyo poti mwadzidzidzi watha kuzindikira.

Asanayambe kuukira, zizindikiro zotsatirazi zimawonekera:

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

Chifukwa cha chizindikiro, chomwe chimapangitsa kuti anthu azikhala ndi njala nthawi zambiri, munthu nthawi zambiri amakhala wonenepa kwambiri.

Pathological anatomy ya hyperinsulinism

Ndi hyperplasia yachilengedwe yotupa kwambiri, kapamba sikuwoneka kosiyana ndi abwinobwino.Macroscopically, insulomas nthawi zambiri amakhala ochepa kukula, monga lamulo, mainchesi awo amafikira masentimita 1-2 okha, osachepera 5-6 masentimita. Zotupa zazikulu nthawi zambiri zimatha kukhala zopanda mphamvu m'thupi, zopanda mphamvu, kapena zopweteka. Zotsirizirazi nthawi zambiri zimakhala zopanda phokoso, zimatha kufika 500-800 g. Benign insulomas nthawi zambiri imasiyanasiyana mosasinthasintha (wandiweyani, koma osati nthawi zonse) komanso utoto kuchokera pancreas, kupeza yoyera, imvi kapena yapinki.

Ma insulomas ambiri (75%) amakhala kumanzere kwa kapamba ndipo makamaka mchira wake, zomwe zimatengera zilumba zambiri zomwe zili mbali iyi ya gland. Ma insulomas nthawi zonse amakhala ndi kapisozi womveka bwino, ndipo zotupa zambiri zimakhala pang'ono kapena kulibeko kwathunthu. Kubvuta kwa insulin sikungokhala kokha pakubisa, komanso m'mitundu yosiyanasiyana yama cellular, ngakhale ali ndi magawo wamba (ochokera ku maselo a beta). Izi zimapangitsa kuti chizolowezi cha morphological chizindikirike pozindikira zotupa zopanda pake kapena zoyipa, ndipo kumayambiriro kwa chitukuko, njira zodziwikiratu malire pakati pa islet hyperplasia ndi chitukuko cha blastoma ndizosakwanira.

Mwa insulomas yomwe tafotokozazi, osachepera 9% ndi ovulala ndipo ena mwa omwe adatsatana kale ndi metastase. Zotupa za Benign nthawi zambiri zimakhala za alveolar ndi trabecular, nthawi zambiri zomwe zimakhala za tubular ndi papillomatous. Amakhala ndimapangidwe ang'onoang'ono ngati cylindrical, ndipo nthawi zambiri amakhala ndi maselo a polygonal (kuchokera wamba kupita kwa atypical) okhala ndi wotumbululuka kapena alveolar cytoplasm, okhala ndi maukono aakulu. Minofu ya Interstitial imakhala ndi zizindikiro za hyalinosis ndi kapangidwe kazinthu zopangika kapena zamitundu yambiri, zotupa ndi zotupa m'matumbo stroma. Mu zotupa zoyipa, cell atypism imachulukanso, hyperchromatosis, mitosis imawoneka, pali zizindikiro zakulowerera ndikukula kwa maselo otupa kunja kwa kapisozi, komanso kulowa kwa lumen kwa magazi ndi ziwiya zamitsempha.

Kukula kwa hyperinsulinism

Mankhwala othandizira amkati hyperinsulinism, wophatikizira kuchotsedwa kwantuloma, amapereka zotsatira zabwino, kupatula momwe zotsatira za hypoglycemic zimawonekera. Kumayambiriro kwa matendawa, kudaliraku ndikabwino kwambiri, ndipo mtsogolo, makamaka ngati kuchedwa kuchotsera kuukira kwa hypoglycemic kumakhala kovuta pokhudzana ndi thanzi ndi moyo. Kuchotsa kwachangu kwa matenda a hypoglycemia ndipo, makamaka, kupewa izi mwazowonjezera zomwe zimapangidwa ndizakudya zopatsa mphamvu zamthupi, zimapangitsa kuti thupi likhale lathanzi komanso nthawi yotsala ya matenda a hypoglycemic, ngakhale zimathandizira kunenepa kwambiri. Komanso, zomwe zimachitika chifukwa cha matendawa zimakhala zopanda tanthauzo ndipo chithandizo cha opaleshoni cha hyperinsulinism chimapangitsa kuti matendawa akhale abwino ngakhale atadutsa nthawi yayitali matendawo. Zizindikiro zonse za matenda a hypoglycemic zimatha, ndipo kunenepa kwambiri kumadutsanso. Popanda thandizo la panthawi yake ndi hypoglycemia yowonjezereka, chiwopsezo pamoyo wa wodwalayo chimapangidwa nthawi zonse.

Zakonzedwa ndikuwongoleredwa ndi: dokotala wa opaleshoni

Matenda ambiri osachiritsika nthawi zambiri amakhala isanayambike matenda ashuga.

Kodi kukana insulin ndi chiyani?

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

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

Izi zimabweretsa kuthamanga kwa magazi, kudzikundikira kwama deposits amafuta ndi kutupa kwa minofu yofewa.

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

Pali chiphunzitso chakuti kukana insulini ndi njira yoteteza kuti munthu apulumuke mikhalidwe yoopsa (mwachitsanzo, ndi njala yayitali).

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

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

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

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

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

Hyperinsulinemia: zimayambitsa, Zizindikiro, mankhwala, zakudya

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

thumba losunga mazira
adrenal kotekisi
kapamba
zodabwisa
hypothalamus.

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

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

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

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

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

Kodi polycystic ndi hyperinsulinemia amawonetsedwa bwanji?

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

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

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

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

Ngati wodwalayo apita kwa dokotala, ndiye kuti pakhala woyamba kuzindikira pamakina a ultrasound, omwe angayambitse mawonekedwe ambiri a cystic, makulidwe amitsempha yam'mimba, endometrial hyperplasia mu chiberekero. Njira zoterezi zimatsatiridwa ndikumverera kowawa pamimba yotsika ndi m'chiuno, ndipo zomwe zimayambitsa ziyenera kukumbukiridwa.

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

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

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

Polankhula manambala, kuchokera pa 5 mpaka 10 peresenti ya azimayi amisinkhu yosabereka amakhala ndi vuto losunga mazira a polycystic, ngakhale kuti zomwe zimayambitsa vutoli zimadziwika.

Kodi hyperinsulinemia ndi polycystosis amathandizidwa bwanji?

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

Ntchito yayikulu pamenepa ndi kubweretsa kulemera kwa chizolowezi.

Pachifukwachi, calorie amaletsa chakudya chama calories 1800 patsiku, chakudya chomwe chili ndi shuga wambiri pamenepa chizichita ngati mtundu wa chithandizo. Ndikofunika kuchepetsa kugwiritsa ntchito momwe mungathere:

mafuta
zonunkhira
zonunkhira
chakudya chokometsera
zakumwa zoledzeretsa.

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

Kodi hyperinsulinemia ndi chiyani ndipo ndi chifukwa chiyani?

Matenda ambiri osachiritsika nthawi zambiri amakhala isanayambike matenda ashuga.

Zizindikiro za Hyperinsulinemia

Kudziwa chizindikiro cha hyperinsulinemia nthawi zina kumakhala kovuta. Poyamba, mawonekedwe abwinobwino ndi ake. Ndipo, odwala ambiri ali ndi zizindikiro zofanana:

Kuchepa kwakanthawi kwa minofu
Chizungulire
Kutopa popanda chifukwa chodziwikiratu.
Kulephera kulolera
Zowonongeka ndi diplopia
Kugwedezeka, kuzizira
W ludzu

Hyperinsulinemia Chithandizo

Popeza uku si kuzindikira, koma mkhalidwe wowawa, chithandizo chake chimachokera pakuchotsa zomwe zimayambitsa, kutsatira zakudya ndi kuwongolera zakudya, kuchepetsa kulemera ndikuwongolera shuga la wodwalayo. Nthawi zina, odwala amapatsidwa mankhwala. Ngati malingaliro onsewa akatsatiridwa, ndiye kuti boma lingathe kugonja. Miyezo ya insulini pang'onopang'ono ibwerera mwakale. Mankhwala okha ndi zakudya za hyperinsulinemia ziyenera kuchitika kwa nthawi yayitali, ndipo mwina nthawi zonse. Izi ndizofunikira kwambiri: phunzirani kukhala ndi moyo ndi kudya malinga ndi malamulo atsopano. Mbatata ndi nyama yamafuta siziyenera kulekanitsidwa ndi zakudya wamba, onjezerani masamba ambiri patebulo lanu ndikupangitsa chakudyacho kukhala chabwino. Mukanyalanyaza malangizo awa kapena omwe adokotala adapereka okhudzana ndi kadyedwe, hyperinsulinemia imatha kubweretsa zotsatirapo zosasangalatsa:

Hypoglycemia
Matenda a shuga
Matenda oopsa
Matenda amitsempha yamagazi
Kuchulukitsa kwa CVD
Kulemera
Lethargy

Ndemanga ndi ndemanga

Margarita Pavlovna - Feb 25, 2019 9:59 p.m.

Ndili ndi matenda a shuga a 2 - osadalira insulin. Mnzake adalangiza kuti achepetse shuga m'magazi ndi DiabeNot. Ndinalamula kudzera pa intaneti. Adayamba kulandira. Ndimatsata zakudya zosasamala, m'mawa uliwonse ndidayamba kuyenda ma kilomita 2-3 ndikuyenda pansi. M'masabata awiri apitawa, ndazindikira kuchepa kwa shuga m'mamawa m'mawa asanadye chakudya cham'mawa kuyambira 9,3 mpaka 7.1, ndipo dzulo ngakhale mpaka 6.1! Ndikupitiliza njira yodzitetezera. Ndileka zolemba zabwino.