Matenda a pancreatic

Ndi polypeptide yopanga maunyolo awiri A ndi B, yolumikizidwa

milatho yopanda malire, mu insulin ya anthu 51 amino acid ndi MM 5.7 D.

Amapangidwa m'maselo a kapamba mu mawonekedwe a proinsulin, mwanjira iyi

imanyamula m'miyala yazinsinsi ndipo pano insulin ndi C - peptide zimapangidwa.

Yambitsani kaphatikizidwe ndi katulutsidwe:

• glucose wamagazi, poyambira ndende ya insulin katulutsidwe ndi 5.5 mmol / l,

• mafuta acids ndi amino acid,

• mahomoni a GIT: cholecystokinin, secretin, gastrin, enteroglucagon, gastric

• kukhudzika kosatha kwa mahomoni okula, glucocorticoids, estrogens, pro

Pambuyo pomanga insulin ku receptor, mphamvu ya enzymatic imayendetsedwa

cholandirira. Popeza ili ndi tyrosine kinase ntchito, imapanga phosphorylates

• kutsegula kwa glycolysis ndi glycogenogeneis

• kuchuluka kwa TAG ndi VLDL

• imalimbikitsa mayendedwe a glucose m'maselo

• imakulitsa mayendedwe achilengedwe amino acid kumitsempha

• imalimbikitsa kutanthauzira, ie ribosomal mapuloteni synthesis

• imalimbikitsa mayendedwe a glucose m'maselo

• imayendetsa lipoprotein lipase synthesis

• imachepetsa ntchito ya lipase ya intracellular

P A T O L O G I

Insulin yodalira ndi insulin yosadalira insulin

GL Y K A G O N

Ndi polypeptide yophatikizapo 29 amino acid okhala ndi molekyulu

masekeli 3485 Inde ndi theka-moyo wa 3-6 mphindi.

Imachitika m'maselo a kapamba ndi m'maselo a m'matumbo aang'ono.

Kuchepetsa kaphatikizidwe kagayidwe.

• Kukhazikitsa kwa gluconeogeneis ndi glycogenolysis

Zimawonjezera ntchito ya TAG-lipase ya intracellular yokhudza chidwi.

Pancreas, mahomoni ake ndi zizindikiro

Zikondwerero - chitsulo chachiwiri chachikulu pamakina am'mimba, kukula kwake ndi 60-100 g, kutalika ndi 15-22 cm.

Ntchito ya endocrine ya kapamba imachitika ndi zisumbu za Langerhans, zomwe zimakhala ndi mitundu yosiyanasiyana ya maselo. Pafupifupi 60% ya magwiritsidwe apake pancreatic ndi β-cell. Amatulutsa mahomoni insulin, yomwe imakhudza mitundu yonse ya kagayidwe, koma makamaka imachepetsa shuga wa plasma.

Gome. Matenda a pancreatic

Insulin (polypeptide) ndi puloteni yoyamba kupangidwa kunja kwa thupi mu 1921 ndi Baileys ndi Banti.

Insulin imakulitsa kwambiri kupezeka kwa nembanemba yama cell am'mimba ndi mafuta kwa glucose. Zotsatira zake, kuchuluka kwa kusintha kwa glucose m'maselo amenewa kumawonjezeka pafupifupi nthawi 20 poyerekeza ndi kusintha kwa glucose kukhala maselo popanda insulin. M'maselo am'misempha, insulin imalimbikitsa kuphatikiza kwa glycogen kuchokera ku glucose, ndipo m'maselo a mafuta - mafuta. Mothandizidwa ndi insulin, kupezeka kwa membrane wam'maselo kumawonjezeranso ma amino acid omwe mapuloteni amapangidwa m'maselo.

Mkuyu. Mahomoni akuluakulu omwe amakhudza glucose wamagazi

Yachiwiri pancreatic timadzi glucagon - yotulutsidwa ndi ma cell a mabulogu (pafupifupi 20%). Glucagon ndi polypeptide mwa chikhalidwe chake, komanso insulini yotsutsana ndi zochita zathupi. Glucagon imathandizira kutsika kwa glycogen m'chiwindi ndikuwonjezera kuchuluka kwa shuga m'magazi am'magazi. Glucagon imathandizira kusuntha mafuta kuchokera kumafayiti amafuta. Ma mahomoni angapo amachita ngati glucagon: STH, glucocorticond, adrenaline, thyroxine.

Gome. Zotsatira zazikulu za insulin ndi glucagon

Mtundu wosinthana

Insulin

Glucagon

Kuchulukitsa kuchuluka kwa masanjidwe am'mimba a glucose ndikugwiritsa ntchito kwake (glycolysis)

Zimapangitsa kapangidwe ka glycogen

Amachepetsa shuga

Zimapangitsa glycogenolysis ndi gluconeogeneis

Imakhala ndi zotsutsana

Kuchulukitsa magazi

Chiwerengero cha matupi a ketone m'magazi amachepetsa

Kuchuluka kwa matupi a ketone m'magazi kumachuluka

Homoni yachitatu ya kapamba ndi somatostatin yotetezedwa ndi maselo asanu (pafupifupi 1-2%). Somatostatin amaletsa kumasulidwa kwa glucagon ndi mayamwidwe a shuga m'matumbo.

Hyper- ndi Hypofunction wa kapamba

Pamene hypofunction ya kapamba imachitika matenda ashuga. Amadziwika ndi zizindikiro zingapo, zomwe zimachitika zomwe zimagwirizanitsidwa ndi kuwonjezeka kwa shuga m'magazi - hyperglycemia. Kuchuluka kwa glucose m'magazi, motero mu kusefedwa kwa glomerular, kumabweretsa mfundo yoti mafupa aubongo epithelium samatenga glucose kwathunthu, chifukwa chake amayamba kuthira mkodzo (glucosuria). Pali kutaya kwa shuga mkodzo - shuga pokodza.

Kuchuluka kwa mkodzo (polyuria) kuyambira 3 mpaka 12, ndipo nthawi zina, mpaka 25 malita. Izi ndichifukwa choti glucose wosasakanizidwa umachulukitsa kuthamanga kwa mkodzo, komwe kumakhala madzi. Madzi samamwetsa mokwanira ma tubules, ndipo kuchuluka kwa mkodzo wothira impso kumawonjezereka. Kuthetsa madzi kumapangitsa ludzu kwa odwala matenda a shuga, omwe amachititsa kuti pakhale madzi ambiri (pafupifupi 10 l). Pokhudzana ndi kutuluka kwa glucose mu mkodzo, kuwononga mphamvu kwa mapuloteni ndi mafuta monga zinthu zomwe zimatsimikizira kuti kagayidwe kamphamvu kwambiri m'thupi limakwera kwambiri.

Kuchepa kwa makutidwe ndi okosijeni a glucose kumapangitsa kuti mafuta asokonekera. Katundu wa mafuta osakwanira amafuta amapangidwa - matupi a ketone, omwe amachititsa kuti magazi asinthidwe kupita kumbali ya acid - acidosis. Kudzikundikira kwa matupi a ketone ndi acidosis kumatha kuyambitsa vuto lalikulu, lowopsa - wodwala matenda ashuga, yomwe imachitika ndikusiya chikumbumtima, kupuma movutikira komanso kuthamanga kwa magazi.

Pancreatic hyperfunction ndi matenda osowa kwambiri. Insulin yowonjezera m'magazi imapangitsa kuchepa kwambiri kwa shuga mu izo - hypoglycemiazomwe zimapangitsa kuti mukhale osazindikira - hypoglycemic chikomokere. Ichi ndichifukwa chapakati mantha amachepetsa kwambiri kuperewera kwa shuga. Kubweretsa shuga kumachotsa zinthu zonsezi.

Pancreatic function regulation. Kupanga kwa insulin kumayendetsedwa ndi njira yolakwika yotsata kutengera kuchuluka kwa shuga m'magazi am'magazi. Kuchuluka kwa shuga m'magazi kumachulukitsa kupanga insulini, pomwe hypoglycemia, mapangidwe a insulini, m'malo mwake, amakhala oletsedwa. Kupanga kwa insulin kumatha kuwonjezeka ndi kukondoweza kwa mitsempha ya vagus.

Pancreatic endocrine ntchito

Zikondwerero (akulemera 70-80 g) ali ndi ntchito yosakanikirana. Tizilombo tosiyanasiyana tamatulutsa timatulutsa timadzi timene timapukutika, timene timatulutsidwa m'mafuta a duodenum. Ntchito ya endocrine mu kapamba imachitika ndi masango (kuyambira 0,5 mpaka 2 miliyoni) maselo a epithelial, omwe amatchedwa islets of Langerhans (Pirogov-Langerhans) ndipo amapanga 1-2% ya kuchuluka kwake.

Malangizo a paracrine a Langerhans islet cell

Pali mitundu ingapo ya maselo amtundu wa endocrine m'masukulu:

• maselo (pafupifupi 20%) amapanga glucagon,
• β-cell (65-80%), kupanga insulin,
• Maselo δ-cell (2-8%) amapanga somatostatin,
• Maselo a PP (ochepera 1%) omwe amapanga pancreatic polypeptide.

Ana aang'ono ali ndi ma G-cell omwe amapanga gastrin. Mahomoni akuluakulu apachifini omwe amawongolera njira za metabolic ndi insulin ndi glucagon.

Insulin - polypeptide yophatikiza maunyolo awiri (the A chain is 21 amino acid residues and B chain of 30 amino acid zotsalira) cholumikizidwa pamodzi ndi mabuluni a disulfide. Insulin imayenda ndi magazi makamaka m'malo opanda ufulu ndipo nkhani zake ndi 16-160 mkU / ml (0.25-2.5 ng / ml). Patsiku lililonse (maselo atatu a munthu wathanzi labwino amatulutsa 35-50 magawo a insulin (pafupifupi 0.6-1.2 magawo / kg).

Gome. Njira za glucose zimayendera cell

Mtundu wa nsalu

Limagwirira

Puloteni yonyamula ya GLUT-4 ndiyofunikira kuti mayendedwe a glucose azitha kupezeka mu cell

Mothandizidwa ndi insulin, mapuloteniwa amasunthira kuchoka ku cytoplasm kupita ku membrane wa plasma ndipo glucose amalowa mu khungu kudzera mwa kulowetsedwa

Kukondoweza ndi insulin kumapangitsa kukulitsa kuchuluka kwa glucose kulowa mu cell chifukwa cha 20 mpaka 40. Kutumiza kwa glucose mu minofu ndi minyewa ya adipose kumadalira insulin.

Mapuloteni osiyanasiyana amtundu wa glucose transporter (GLUT-1, 2, 3, 5, 7) ali mgulu la cell, lomwe limalumikizana ndi nembanemba mosiyanasiyana insulin

Pogwiritsa ntchito mapuloteniwa, kudzera mwa kuphatikizika, glucose amatumizidwa mu cell ndi gradient ya ndende

Zida zosadalira insulini zimaphatikizapo: ubongo, m'mimba epithelium, endothelium, maselo ofiira am'magazi, ma lens, ma cell a maselo a Langerhans, medulla ya impso, seminal vesicles

Katemera wa insulin

Katemera wa insulin amagawidwa kukhala woyambira, wokhala ndi phokoso lotchedwa circadian, ndipo amalimbikitsidwa ndi chakudya.

Secaltion ya basal imapereka mulingo wambiri wa glucose m'magazi ndi njira za anabolic m'thupi panthawi yogona komanso mosiyanasiyana pakati pa chakudya. Ndipafupifupi 1 U / h ndipo imasankha 30-50% ya katulutsidwe ka insulin tsiku ndi tsiku. Secretion woyambira umachepetsedwa kwambiri ndi nthawi yayitali zolimbitsa thupi kapena kufa ndi njala.

Katemera wolimbikitsidwa ndi chakudya ndikuwonjezereka kwa secaltion ya basal insulin chifukwa cha chakudya. Voliyumu yake ndi 50-70% ya tsiku lililonse. Katulutsidwe kameneka kamatsimikizira kukhathamiritsa kwa glucose m'magazi pansi pa zinthu zina zowonjezera kuchokera m'matumbo, ndipo zimapangitsa kuyamwa bwino ndikugwiritsa ntchito maselo. Kukula kwa kubisalira kumatengera nthawi ya tsiku, ali ndi magawo awiri. Kuchuluka kwa insulini yomwe imatulutsidwa m'magazi pafupifupi imafanana ndi kuchuluka kwa chakudya chotengedwa ndipo imakhala yamagulu a insulini 1-2.5 zama protein (m'mawa 2-2,5, masana - 1-1.5 magawo, madzulo - pafupifupi 1 unit ) Chimodzi mwazifukwa za kudalira kwa insulin katulutsidwe panthawi ya tsiku ndiwokwera kwambiri m'magazi a mahomoni opatsirana (makamaka cortisol) m'mawa ndikuchepa kwake madzulo.

Mkuyu. Njira ya insulin katulutsidwe

Gawo loyambirira (pachimake) la insulin yolimbikitsidwa sichikhala nthawi yayitali ndipo limagwirizanitsidwa ndi exocytosis ndi β-cell ya mahomoni omwe amapezeka kale pakati pa chakudya. Ndizotheka chifukwa cha kukondoweza kwa ma not-cell osakhala ndi glucose ochulukirapo monga mahomoni am'mimba thirakiti - gastrin, enteroglucagon, glycine, glucagon-peptide 1, wobisika m'magazi panthawi ya chakudya ndi chimbudzi. Gawo lachiwiri la insulin katulutsidwe amayamba chifukwa cha insulin katulutsidwe ka maselo a p ndipo ndi shuga wambiri, mulingo womwe m'magazi umatuluka chifukwa cha kuyamwa. Kuchita ndi kuwonjezeka kwa insulini kumapitirirabe mpaka kuchuluka kwa glucose kumakhala koyenera kwa munthu wopatsidwa, i.e. 3.33-5.55 mmol / L m'magazi a venous ndi 4.44-6.67 mmol / L m'magazi a capillary.

Insulin imagwira maselo olimbana ndi kukondoweza ma membrane a 1-TMS okhala ndi ntchito ya tyrosine kinase. Maselo akuluakulu a insulini ndi hepatocytes a chiwindi, mafupa am'mimba otupa, adipocytes a adipose minofu. Chimodzi mwazofunikira zake ndi kuchepa kwa shuga m'magazi; insulin imathandizira kudzera mu kuyamwa kwa glucose m'magazi ndi maselo omwe akufuna. Izi zimatheka pokhazikitsa ntchito ya transmembrane glucose transmitter (GLUT4), yomwe imalowetsedwa m'zigawo za plasma za maselo chandamale, ndikuwonjezera kuchuluka kwa kusintha kwa glucose kuchoka m'magazi kupita ku maselo.

Amapangidwa ndi 80% insulin m'chiwindi, ena onse mu impso komanso ochepa m'misempha ndi mafuta. Hafu ya moyo wake kuchokera m'mwazi ili pafupifupi mphindi 4.

Zotsatira zazikulu za insulin

Insulin ndi mahomoni a anabolic ndipo amakumana ndi zotsatirapo zingapo pama cell a chandamale osiyanasiyana. Zakhala zikudziwika kale kuti imodzi mwazofunikira zake - kutsitsa shuga m'magazi kumazindikira ndikuwonjezera mayamwidwe ake ndi maselo omwe akuwoneka bwino, ndikufulumizitsa njira za glycolysis ndi oxidation zama carbohydrate mwa iwo. Kukondoweza kwa kapangidwe ka glycogen mu chiwindi ndi minofu ndi insulin kumapangitsa kuchepa kwa shuga, komanso kuponderezedwa kwa gluconeogeneis ndi glycogenolysis m'chiwindi. Insulin imathandizira kuyamwa kwa ma amino acid ndi maselo omwe akufuna, amachepetsa mphamvu ya catabolism komanso imathandizira kaphatikizidwe ka mapuloteni m'maselo. Zimathandizanso kutembenuka kwa glucose kukhala mafuta, kuchuluka kwa ma triacylglycerols mu adipocytes a adipose minofu, ndikuletsa lipolysis mwa iwo. Chifukwa chake, insulin imakhala ndi zotsatira zambiri za anabolic, zimathandizira kaphatikizidwe kazinthu zamafuta, mafuta, mapuloteni ndi ma nucleic acids m'maselo omwe ali ndi chandamale.

Insulin ili ndi zovuta zina zingapo pamaselo, omwe amagawika m'magulu atatu kutengera kuthamanga kwa mawonekedwe. Zotsatira zake mwachangu anazindikira masekondi atamangidwa kwa hormone kupita ku receptor, mwachitsanzo, kuphatikiza kwa glucose, amino acid, ndi potaziyamu ndi maselo. Zotsatira zoyipa zikuwonekera mphindi kuchokera kumayambiriro kwa zochita za timadzi - kuletsa ntchito ya mapuloteni catabolism michere, activation mapuloteni. Zochedwetsedwa insulini imayamba patatha maola angapo itamangidwa kwa ma receptor - Kulemba kwa DNA, kutanthauzira kwa mRNA, kuthamangitsa kukula kwa maselo ndi kubereka.

Mkuyu. Njira ya zochita za insulin

Woyang'anira wamkulu wa basal secretion wa insulin ndi shuga. Kuwonjezeka kwa zomwe zili m'magazi mpaka kufika pamwamba pa 4.5 mmol / L kumayendera limodzi ndi kuwonjezeka kwa insulin kutchinga ndi njira yotsatira.

Glucose → inathandizira kusokonezeka ndi gawo la transporter ya transutter GLUT2 mu β-cell → glycolysis ndi kuchuluka kwa ATP → kutseka kwa potaziyamu njira yodziwika ndi ATP → kuchedwa kumasulidwa, kudziwitsidwa kwa K + ions mu cell ndikuwonongeka kwa membrane wake → kutsegulira kwa njira zopangira calcium yodalira calcium + mu khungu → kudzikundikira kwa Ca2 + ions mu cytoplasm → kuchuluka kwa insulin exocytosis. Katulutsidwe wa insulin kamakhudzidwa chimodzimodzi ndi kuwonjezeka kwamagazi a galactose, mannose, β-keto acid, arginine, leucine, alanine ndi lysine.

Mkuyu. Malangizo a insulin katulutsidwe

Hyperkalemia, sulfonylurea derivatives (mankhwala ochizira matenda amishuga 2), poletsa njira zam potaziyamu za membrane wa plasma a β-cell, kuwonjezera ntchito yawo yachinsinsi. Kuchulukitsa katulutsidwe ka insulin: gastrin, secretin, enteroglucagon, glycine, glucagon-ngati peptide 1, cortisol, mahomoni okula, ACTH. Kuwonjezeka kwa insulin katulutsidwe ka acetylcholine kumaonekera pa kutsegula kwa parasympathetic department of the ANS.

Kuletsa kwa insulin katulutsidwe kumawonedwa ndi hypoglycemia, motsogozedwa ndi somatostatin, glucagon. Ma catecholamine omwe amatulutsidwa ndikuwonjezera ntchito za SNS ali ndi zoletsa.

Glucagon - peptide (zotsalira 29 za amino acid) zopangidwa ndi ma cell a islet zida za kapamba. Imasamutsidwa ndi magazi m'malo opanda ufulu, momwe zili 40 4050 pg / ml. Imakhala ndi zotulukapo zake pamaselo am'manja, olimbikitsa 7-TMS receptors ndikuwonjezera kuchuluka kwa cAMP mwa iwo. Hafu ya moyo wa mahormoni ndi mphindi 5-10.

Contrinsular zochita za glucogon:

• Imayendetsa maselo a β maselo a ma Langerhans, ndikuwonjezera katemera wa insulin
• Amayambitsa insulinase ya chiwindi
• Imakhala ndi zotsutsana ndi kagayidwe.

Chithunzi chojambula chogwira ntchito chomwe chimachirikiza kuchuluka kwa glucose wokwanira kagayidwe

Zotsatira zazikulu za glucagon m'thupi

Glucagon ndi hormone ya catabolic ndi insulin wotsutsana naye. Mosiyana ndi insulin, imachulukitsa shuga m'magazi ndikulimbikitsa glycogenolysis, kupondereza glycolysis, komanso zolimbikitsa gluconeogeneis mu chiwindi hepatocytes.Glucagon imayambitsa lipolysis, imayambitsa kuchuluka kwamafuta acid kuchokera ku cytoplasm kupita ku mitochondria awo β-oxidation ndikupanga matupi a ketone. Glucagon imapangitsa kagayidwe kazakudya zomanga thupi mu minofu ndikukulitsa kaphatikizidwe ka urea.

Glucagon secretion imalimbikitsidwa ndi hypoglycemia, kuchepa kwa amino acid, gastrin, cholecystokinin, cortisol, ndi kukula kwa mahomoni. Kuchulukitsa katulutsidwe kumawonedwa ndi ntchito yowonjezereka ya SNS ndi kukondoweza kwa β-AR ndi catecholamines. Izi zimachitika pakulimbitsa thupi, kufa ndi njala.

Glucagon secretion imalepheretsedwa ndi hyperglycemia, kuchuluka kwamafuta acid ndi matupi a ketone m'magazi, komanso motsogozedwa ndi insulin, somatostatin ndi secretin.

Pancreatic endocrine kukanika zimachitika mu mawonekedwe osakwanira kapena obisalira kwambiri mahomoni ndipo zimayambitsa kuphwanya kwakuthwa kwa glucose homeostasis - kukula kwa hyper- kapena hypoglycemia.

Hyperglycemia - uku ndi kuwonjezeka kwa shuga m'magazi. Ikhoza kukhala yovuta komanso yopanda matenda.

Acute hyperglycemia Nthawi zambiri zimakhala zachitukuko, chifukwa nthawi zambiri zimayamba chifukwa cha kuchuluka kwa shuga m'magazi tikatha kudya. Kutalika kwake sikumapitilira maola 1-2 chifukwa chakuti hyperglycemia imalepheretsa kubisika kwa glucagon komanso imathandizira kubisalira kwa insulin. Ndi kuwonjezeka kwa shuga m'magazi pamwamba pa 10 mmol / l, amayamba kuthira mkodzo. Glucose ndi chinthu chomwe chimagwira ntchito mosiyanasiyana, ndipo kuchuluka kwake kumayendetsedwa ndi kuwonjezeka kwa magazi a osmotic, omwe angayambitse kuchepa kwamaselo m'maselo, kukula kwa osmotic diuresis ndi kuchepa kwa ma elekitirodi.

Matenda a hyperglycemia, momwe kuchuluka kwa glucose m'magazi kumapitilira kwa maola, masiku, masabata kapena kupitilira apo, kumatha kuwononga zimakhala zambiri (makamaka mitsempha yamagazi) motero imawerengedwa ngati mkhalidwe wa pre-pathological and (kapena). Ndi chizindikiro cha gulu lonse la matenda a metabolic ndi endocrine gland dysfunctions.

Chimodzi mwazofala kwambiri komanso zowopsa pakati pawo matenda ashuga (DM), yomwe imakhudza anthu 5-6%. M'mayiko otukuka kwachuma, kuchuluka kwa odwala matenda ashuga kumachulukanso zaka khumi ndi zisanu zilizonse. Ngati matenda a shuga amayamba chifukwa chophwanya insulin ya maselo a β-cell, ndiye kuti amatchedwa mtundu 1 shuga mellitus - shuga-1. Matendawa amathanso kuyamba ndi kuchepa kwa mphamvu ya insulin pama cell aanthu achikulire, ndipo imatchedwa mtundu 2 shuga mellitus - SD-2. Nthawi yomweyo, chidwi cha maselo olimbana ndi insulin amachepetsa, omwe amatha kuphatikizidwa ndi kuphwanya kwa chinsinsi cha ntchito za p-maselo (kutayika kwa gawo la 1 la secretion ya chakudya).

Hyperglycemia (kuwonjezeka kwa kuthamanga kwa glucose m'magazi pamwamba pa 5.55 mmol / L) ndi chizindikiro chofala cha matenda a shuga 1 ndi mtundu 2 shuga. Mwazi wa glucose ukakwera kufika 10 mmol / L kapena kuposerapo, shuga amapezeka mkodzo. Imachulukitsa kuthamanga kwa mkodzo ndi kuchuluka kwa mkodzo womaliza ndipo izi zimayenda limodzi ndi polyuria (kuwonjezereka kwa pafupipafupi komanso kuchuluka kwa mkodzo wothira mpaka 4-6 l / tsiku). Wodwalayo amayamba ludzu ndikuwonjezera madzi amadzimadzi (polydipsia) chifukwa cha kuchuluka kwa magazi ndi mkodzo. Hyperglycemia (makamaka ndi DM-1) nthawi zambiri imayendera limodzi ndi kudzikundikira kwa zinthu zomwe sizimakwanira oxidation wamafuta acid - hydroxybutyric and acetoacetic acids (matupi a ketone), omwe amawonetsedwa ndi mawonekedwe a fungo la mpweya wotuluka komanso (kapena) mkodzo, kukula kwa acidosis. Woopsa milandu, izi zingayambitse kuphwanya kwa chapakati mantha dongosolo - kukula kwa chikomokere matenda a shuga, limodzi ndi kusazindikira ndi kufa kwa thupi.

Zokwanira za insulini (mwachitsanzo, nthawi ya insulin m'malo mwake kapena kukondoweza kwawobisalira ndi kukonzekera kwa sulfanylurea) kumabweretsa hypoglycemia. Kuopsa kwake kuli m'kuti glucose imakhala gawo lalikulu lamphamvu kwa maselo aubongo ndipo, pamene chikhazikitso chake chatsitsidwa kapena kulibe, ubongo umasokonezeka chifukwa chazovuta, kuwonongeka komanso (kapena) kufa kwa ma neuron. Ngati shuga wochepetsedwa amatha nthawi yayitali, ndiye kuti imfa ingachitike. Chifukwa chake, hypoglycemia ndi kuchepa kwa shuga m'magazi ochepera 2.2-2.8 mmol / l) imawerengedwa ngati mkhalidwe momwe dokotala wamtundu uliwonse ayenera kuperekera thandizo kwa wodwala.

Hypoglycemia imagawika pawiri, yomwe imachitika mukatha kudya komanso pamimba yopanda kanthu. Zomwe zimapangitsa kuti mafuta ena azigwiritsa ntchito (hypoglycemia) ndi kuwonjezereka kwa insulin mukatha kudya ndi kuphwanya kwa chibadwa cha kulolerana kwa shuga (fructose kapena galactose) kapena kusintha kwa chidwi cha amino acid leucine, komanso kwa odwala omwe ali ndi insulinoma (chotupa cha β-cell). Zomwe zimayambitsa kusala kudya kwa hypoglycemia kumatha kukhala - kusakwaniritsidwa kwa machitidwe a glycogenolysis ndi (kapena) gluconeogeneis m'chiwindi ndi impso (mwachitsanzo, ndi kuchepa kwa mahomoni olimbana ndi mahomoni: glucagon, catecholamines, cortisol), kugwiritsa ntchito kwambiri glucose ndi minofu, kuchuluka kwa insulin.

Hypoglycemia imadziwonekera m'magulu awiri azizindikiro. Mkhalidwe wa hypoglycemia ndi wopsinjika kwa thupi, poyankha chitukuko chomwe ntchito ya mtima wachifundo ikukwera, kuchuluka kwa katekisimu m'magazi kumawonjezeka, komwe kumayambitsa tachycardia, mydriasis, kunjenjemera, thukuta lozizira, nseru, komanso kumva njala yayikulu. Kufunika kwachilengedwe kwa hypoglycemia kutsegula kwa mtima wachisoni kumayambitsa kukhazikitsidwa kwa mitsempha ya neuroendocrine ya catecholamines kuti ipangitse glucose mwachangu kulowa m'magazi ndikusintha momwe mulili. Gulu lachiwiri la zizindikiro za hypoglycemia limalumikizana ndi kukanika kwa chapakati mantha dongosolo. Amawonetsedwa mwa munthu ndi kuchepa kwa chidwi, kukula kwa mutu, mantha, kusokonezeka, chikumbumtima, kusokonezeka, kufooka, kufuwa. Kukula kwawo kumachitika chifukwa chosowa mphamvu m'magulu amitsempha omwe samatha kulandira ATP yokwanira pakalibe glucose. Ma Neuron alibe njira zothandizira kupangira shuga mu mawonekedwe a glycogen, ngati hepatocytes kapena myocyte.

Dokotala (kuphatikizapo dotolo wamano) ayenera kukhala okonzekera zochitika zoterezi ndikuthanso kupereka thandizo kwa odwala omwe ali ndi matenda ashuga ngati ali ndi hypoglycemia. Musanayambe mankhwala a mano, ndikofunikira kudziwa matenda omwe odwala akudwala. Ngati ali ndi matenda ashuga, wodwalayo ayenera kufunsidwa pazakudya zake, kuchuluka kwa insulin yomwe amagwiritsa ntchito komanso kulimbitsa thupi kwake. Tiyenera kukumbukira kuti kupsinjika komwe kumachitika pakumwa mankhwalawa ndi chiopsezo chowonjezereka cha hypoglycemia mwa wodwala. Chifukwa chake, dotolo wamano ayenera kukhala ndi mtundu uliwonse wa shuga okonzeka - mapaketi a shuga, maswiti, msuzi wokoma kapena tiyi. Ngati wodwala akuonetsa zizindikiro za hypoglycemia, muyenera kusiya njira zamankhwala ndipo ngati wodwalayo akudziwa, mupatseni shuga mkamwa uliwonse. Ngati wodwalayo akuipiraipira, ayenera kuchitapo kanthu mwachangu kuti apereke chithandizo chamankhwala chothandiza.

Udindo wa glucagon mu thupi, limagwirira ntchito

Ubongo, matumbo, impso, ndi chiwindi ndizo zimagwiritsa ntchito shuga. Mwachitsanzo, dongosolo lamkati lazakudya zimadya magalamu anayi a glucose mu 1 ora. Chifukwa chake, ndikofunikira kwambiri kuti ikhalebe yokhazikika.

Glycogen - chinthu chomwe chimasungidwa kwambiri m'chiwindi, ichi ndi nkhokwe pafupifupi 200 gr. Ndi kuchepa kwa glucose kapena pakufunika mphamvu zowonjezera (zolimbitsa thupi, kuthamanga), glycogen imaphwanya, ndikudzaza magazi ndi glucose.

Kusungirako ndikokwanira kwa mphindi 40. Chifukwa chake, pamasewera nthawi zambiri amati mafuta amawotcha atangophunzira theka la ola, pomwe mphamvu zonse za glucose ndi glycogen zimagwiritsidwa ntchito.

Zikondwererozi ndimtundu wa tiziwalo tosakanikirana - umatulutsa madzi am'mimba, omwe amatulutsidwa mu duodenum 12 ndikupanga mahomoni angapo, chifukwa chake minofu yake imapangidwa mwanjira zosiyanasiyana komanso mosiyanasiyana. Ma cell a Alfa amapanga glucagon m'midzi yaying'ono ya Langerhans. Thupi limatha kupangika ndi maselo ena a ziwalo zam'mimba.

Pali zifukwa zingapo zomwe zimayambitsa kubisala kwa mahomoni:

1. Kuchepetsa mphamvu ya shuga m'magawo otsika kwambiri.
2. Mlingo wa insulin.
3. Kuwonjezeka kwa milingo yamagazi amino acid (makamaka, alanine ndi arginine).
4. Kuchita masewera olimbitsa thupi kwambiri (mwachitsanzo, mukamachita masewera olimbitsa thupi kapena olemetsa).

Ntchito za glucagon zimagwirizanitsidwa ndi njira zina zofunika zamapangidwe azachilengedwe ndi zokhudza thupi:

• kuchuluka kwa magazi mu impso.
• kukhalabe ndi mulingo wabwino kwambiri wamagetsi mwakuwonjezera kuchuluka kwa sodium excretion, komwe kumapangitsa ntchito ya mtima,
• kubwezeretsa minofu ya chiwindi,
• kutsegula kwa ma insulin kutulutsa,
• kuchuluka kwa calcium m'maselo.

Muzochitika zovutitsa, ndikuwopseza moyo ndi thanzi, komanso adrenaline, zolimbitsa thupi za glucagon zimawonekera. Imaphwanya glycogen, potero imakulitsa shugaimayendetsa kuperekanso kwa oksijeni kuti ipatse minofu mphamvu yowonjezera. Kuti mukhale ndi shuga wokwanira, glucagon amachita mwachangu ndi cortisol ndi somatotropin.

Mulingo wokwera

Kuchuluka kwa secretion wa glucagon kumalumikizidwa ndi pancreatic hyperfunction, yomwe imayambitsidwa ndi ma pathologies otsatirawa:

• zotupa m'dera la alpha cell (glucagonoma),
• pachimake yotupa m'matumbo a kapamba (kapamba),
• kuwonongeka kwa maselo a chiwindi (cirrhosis),
• aakulu aimpso kulephera
• mtundu 1 shuga
• Cushing's syndrome.

Mavuto aliwonse opsinjika (kuphatikiza ma opaleshoni, kuvulala, kuwotcha), kuchuluka kwa shuga m'thupi (protein glucose), kuchuluka kwa mapuloteni m'zakudya kumapangitsa kuchuluka kwa glucagon, ndipo ntchito zamagetsi ambiri.

Mulingo wotsika

Kuperewera kwa glucagon kumachitika pambuyo pa opaleshoni ya pancreatic (pancreatectomy). Homoniyo ndi mtundu wolimbikitsa wa kudya zinthu zofunika m'magazi ndikusamalira homeostasis. Mlingo wochepetsedwa wa mahomoni umawonedwa ndi cystic fibrosis (matenda amtundu womwe umalumikizidwa ndi kuwonongeka kwa gland ya endocrine), ndi kapamba mu mawonekedwe osakhazikika.

Ikusanthula - zodziwika - momwe mungatengere

Mkhalidwe pamene glucagon imapangidwa mopitirira muyeso imakhala ndi zotsatirapo zoyipa. Thupi limadzaza ndi shuga, mafuta acids. Milandu yakutali siyowopsa, koma kuwonjezeka kwa mahomoni pafupipafupi kumayambitsa tachycardia, matenda oopsa, ndi zina mtima zamtima. Chiwopsezo chokhala ndi neoplasms yoyipa ndichovuta kwambiri.

Kusowa kwa glucagon kwa nthawi yayitali kumabweretsa kuchepa kwa ntchito, chizungulire, chikumbumtima chosavomerezeka, kugwedezeka kwamphamvu, kukokana, kufooka, komanso nseru.

Chifukwa kusanthula kwa mahomoni kumatenga zitsanzo za magazi. Kuti mupeze zotsatira zodalirika, muyenera kukonzekera bwino:

• Kwa maola 10-12 musanayambe phunziroli, pewani kudya.
• Pewani kugwiritsa ntchito insulin, catecholamines ndi mankhwala ena omwe amakhudza magwiridwe antchito. Ngati mankhwala osokoneza bongo sangathetsedwe, izi zikuwonetsedwa pakuwunika.
• Asanalandire magazi, wodwalayo ayenera kugona pansi ndikupumula kwa mphindi 30.

Zotsatira za pharmacological

Mankhwala, glucagon wopangira amagwiritsidwa ntchito pochizira zolinga zoopsa za hypoglycemia ndi zina zokhudzana ndi matenda. Katundu wofanana ndi glucagon amagwiritsidwa ntchito pochiza matenda amtundu wa 2 shuga. Pazifukwa zodziwitsa, mankhwalawa amafunikira pophunzira ziwalo zam'mimba.

Mankhwala okhala ndi mahomoni amaperekedwa ndi madokotala. The pharmacological zochita za glucagon umalimbana:

• kuchuluka kwa kuchuluka kwa shuga,
• Kuchepetsa minyewa,
• kusintha kwa kuchuluka kwa mtima.

Zisonyezero zamankhwala

Mphamvu ya mahomoni pakumata kwa glucose ndi glycogen amagwiritsidwa ntchito pochiza ma pathologies osiyanasiyana. Zowonetsa kugwiritsa ntchito mankhwalawa ndi motere:

• kwambiri hypoglycemia, pamene glucose sangathe kutumizidwa ndi dontho,
• kuponderezedwa kwa kutayika kwam'mimba thirakiti pakuwunika ma radiation,
• odwala matenda amisala monga chithandizo chamankhwala,
• pachimake diverticulitis (kutukusira kwamatumbo ndi mapangidwe ooneka ngati thumba),
• matenda amiseche,
• kumasula minofu yosalala yamatumbo.

Contraindication

Glucagon wa mankhwala amatsutsana matenda ena:

• Hypersensitivity pamagawo a mankhwala,
• hyperglycemia (kuchuluka kwa shuga m'magazi),
• insulinoma (chosaopsa, chosavulaza, chotupa cha masoka a Langerhans a kapamba),
• pheochromocytoma (neoplasm yogwira timadzi yomwe imatulutsa secretion ya catecholamines).

Glucagon kapena "hormone yanjala" imabisa chinsinsi. Ndiwotsutsana ndi insulin ndipo amatenga nawo mbali popititsa patsogolo shuga m'magazi. Kuperewera ndi kusowa kwa mahomoni kumayambitsa ma pathologies osiyanasiyana.

Kupanga kwa glucagon ndi ntchito

Glucagon ndi chinthu cha peptide chomwe chimapangidwa ndi zisumbu za Langerhans ndi maselo ena apachifinya. Kholo la Hormone uyu ndi prroglucagon.

Zokhudzana ndi kapangidwe ka glucagon amakhala ndi shuga wopezeka ndi thupi kuchokera ku chakudya. Komanso kapangidwe ka timadzi timeneti timapangidwa ndi zinthu zomwe zimapangidwa ndi munthu yemwe ali ndi chakudya. Amakhala ndi arginine ndi alanine, zomwe zimachulukitsa kuchuluka kwa zomwe zafotokozedwa m'thupi.

Kuphatikizika kwa glucagon kumakhudzidwa ndi ntchito zolimbitsa thupi ndi masewera olimbitsa thupi. Mukamakulitsa katundu, mphamvuyo imakhala yotchuka kwambiri. Zimayambanso kupanga bwino kwambiri pakusala kudya. Monga woteteza, chinthucho chimapangidwa nthawi ya nkhawa. Kuchita kwake kumakhudzidwa ndikuwonjezeka kwa kuchuluka kwa adrenaline ndi norepinephrine.

Glucagon amagwiritsidwa ntchito kupanga glucose kuchokera ku mapuloteni amino acid. Chifukwa chake, limapereka ziwalo zonse za thupi ndi mphamvu yofunikira kugwira ntchito. Ntchito za glucagon zimaphatikizapo:

• Kuwonongeka kwa glycogen m'chiwindi ndi minofu, chifukwa chomwe glucose omwe amasungidwa pamenepo amatulutsidwa m'magazi ndikuthandizira kagayidwe kamphamvu.
• kuwonongeka kwa lipids (mafuta), komwe kumathandizanso kuti thupi likhale ndi mphamvu,
• kupanga shuga kwa zakudya zopanda mafuta
• Kuwapatsa magazi impso,
• kukweza magazi
• kuchuluka kwa mtima
• antispasmodic zotsatira,
• kuchuluka kwa zamatekisiti,
• kukopa kwa chiwindi
• kuthamanga kwa njira ya kuchotsa masodium ndi phosphorous m'thupi,
• kusintha kwa magnesium,
• kuchuluka kwa calcium m'maselo,
• kuchoka kwa maselo a insulin.

Tiyenera kudziwa kuti glucagon simalimbikitsa kupanga kwa glucose mu minofu, chifukwa alibe ma receptor ofunikira omwe amayankha mahomoni. Koma mndandanda umawonetsa kuti gawo la zinthu mthupi lathu ndilokulirapo.

Glucagon ndi insulin - mahomoni awiri omenyera. Insulin imagwiritsidwa ntchito kupangira shuga m'maselo. Amapangidwa ndi shuga wambiri, kuisunga mosungira. Mphamvu ya zochita za glucagon ndikuti imatulutsa shuga m'maselo ndikuyitsogolera ku ziwalo za thupi kuti ikhale ndi mphamvu. Tiyeneranso kukumbukiranso kuti ziwalo zina za anthu zimamwa glucose, ngakhale magwiridwe antchito a insulin. Izi zimaphatikizapo ubongo wamutu, matumbo (mbali zina zake), chiwindi, komanso impso zonse.Kuti metabolism ya shuga m'thupi ikhale yofunikira, mahomoni ena amafunikanso - iyi ndi cortisol, mahomoni amantha, adrenaline, omwe amakhudza kukula kwa mafupa ndi minofu, somatotropin.

Chikhalidwe cha mahomoni ndi kupatuka pamenepo

Mlingo wa mahomoni a glucagon umatengera zaka za munthu. Akuluakulu, foloko pakati pamtengo wotsika komanso wapamwamba ndi yaying'ono. Gome ndi ili:

Kupatuka kwazomwe kuchuluka kwa kuchuluka kwa mahomoni kungasonyeze matenda. Kuphatikiza, posankha kuchuluka kwa chinthu, izi ndizotheka:

• kwambiri cystic fibrosis wa endocrine tiziwalo timene timayambitsa kupuma,
• kutupa kosatha kwa kapamba,
• kutsika kwa glucagon kumachitika pambuyo pancreatic kuchotsa ntchito.

Ntchito za glucagon ndikuchotsa zina mwazomwe zili pamwambapa. Zinthu zambiri zimakhala ndi imodzi mwazinthu izi:

• kuchuluka kwa shuga chifukwa cha mtundu 1 wa shuga,
• chotupa cham'mimba,
• kutupa kwapakhungu,
• matenda a chiwindi (kusinthika kwa maselo mu minofu yotupa),
• kuchuluka kwa glucocorticoids molingana ndi m'badwo wam'mimba yawo yam'mimba,
• kulephera kwa impso
• kuchita masewera olimbitsa thupi mopitirira malire
• kupsinjika kwa malingaliro.

Vuto la kuchuluka kapena kuchepa kwa mahomoni, dokotalayo amapereka mankhwala ena kuti adziwe matenda olondola. Kuti muwone mulingo wa glucagon, biochemistry yamwazi imachitika.

Othandizira okhala ndi glucagon

Kuphatikizika kwa Glucagon kumachitika kuchokera ku mahomoni a nyama, pogwiritsira ntchito mwayi wokhala ndi thunthu lofanana. Mankhwalawa amamasulidwa mwanjira yamadzimadzi a jakisoni ndi mapiritsi a pakamwa. Zilonda zimaperekedwa kudzera m'mitsempha kapena intramuscularly. Mankhwala ndi mankhwala otsatirawa:

• shuga wochepa shuga
• mankhwala owonjezera a kukhumudwa,
• kufunika kothetsera matumbo,
• Kutonthoza ndi kuwongola minofu yosalala,
• Ndi matenda am'mimba,
• ndikuwunika kwam'mimba.

Malangizowo akufotokozera kuti jakisoni wa jakisoni yemwe amaperekedwa kudzera m'mitsempha kapena ngati sichingatheke kubayitsa mtsempha, kudzera m'mitsempha, ndi 1 ml. Pambuyo pa jakisoni, kuchuluka kwa mahomoni, limodzi ndi kuchuluka kwa shuga, kumawonedwa pambuyo pa mphindi 10.

Mankhwalawa amatha kugwiritsidwa ntchito pochiza ana. Ngati kulemera kwa khanda kumakhala kochepera 20 kg, mlingo sayenera kupitirira 0,5 ml. Kwa ana olemera, mlingo umachokera ku 0,5 mpaka 1 ml. Ngati mphamvu ya kayendetsedwe ka mankhwala sikokwanira, jakisoni amabwerezedwa pambuyo pa mphindi 12. Ndikofunikira kumayamwa kwina.

Kuthandiza ana ndi amayi apakati kungachitike mu chipatala moyang'aniridwa ndi katswiri. Pokonzekera matenda a radiation, 0,25 mg mpaka 2 mg wa mankhwalawa amaphatikizidwa. Mlingo, kutengera mkhalidwe wa wodwala ndi kulemera kwake, amawerengedwa ndi dokotala. Ndi zoletsedwa kumwa mankhwalawa mwanjira iliyonse popanda mankhwala a dokotala.

Ngati mankhwalawa amagwiritsidwa ntchito posamalira mwadzidzidzi, mukatha kumwa, muyenera kudya zinthu zamapuloteni, kumwa kapu ya tiyi wotsekemera wokoma ndikupita kukagona kwa maola awiri.

Ngati glucose ali pansipa, ndiyenera kuchita chiyani?

Dokotala asanafike, mutha kuwonjezera shuga wanu pakudya zakudya zina. Ndi bwino kudya uchi 50 g, womwe umakhala ndi fructose, shuga komanso sucrose. Kupatula apo, fructose yokhayo yomwe ndi yoyipa. Ndipo ngati glucagon ndi glucose sizipangidwa zochuluka kutipatsa shuga, shuga amayenera kutengedwa ngati chakudya.

Thandizani kubwezeretsa tiyi wamphamvu ndi kupanikizana. Pambuyo pa kuchuluka kwambiri kapena kupanikizika kwamanjenje, ndikofunika kudya kwambiri ndi zakudya zopatsa mphamvu kwambiri. Mndandanda wawo umaphatikizapo zakudya zam'nyanja, mtedza, maapulo, tchizi, nthanga za maungu, mafuta a masamba. Phindu limabweretsa mpumulo m'chipinda chotsegulira phokoso komanso kugona tulo tabwino.

Ichi ndi chiyani

Horoni ya polypeptide imapangidwa mu kapamba panthawi yosintha kuchokera ku prroglucagon. Wotsutsana ndi insulin ndikofunikira kuti azitha kuyendetsa bwino kwambiri glycemia m'thupi. Molekyu ya peptide imakhala ndi amino acid 29.

Insulin ndi glucagon zimalumikizana: gawo lachiwiri limalepheretsa ntchito yoyamba. Kuphatikiza kwakukulu kwa oyang'anira kumalepheretsa kuchepa konse komanso kuwonjezereka kwa kuchuluka kwa shuga m'magazi. Kukhazikitsa insulin wotsutsana naye mwachangu kumabwezeretsa shuga m'magazi ndi hypoglycemia.

Glucagon ali ndi dzina lina - "hormone ya njala." Chomwe chimapangitsa ndikusintha kwa zinthu zingapo, mothandizidwa ndi komwe thupi limayimira kusowa mphamvu. Chofunikira ndikubwera kwa ma sign ku bongo zokhudzana ndi kuchepa kwa glucose kuti ayambitse katulutsidwe wa glucagon, chifukwa cha ndondomekoyi kumakhala kumva njala.

Poyerekeza ndi kumbuyo kwa ntchito yolimbitsa thupi, kuchuluka kwa mahomoni a polypeptide amakwera ka 5 kapena kuposerapo, ndikuwonjezereka kwa kuchuluka kwa alanine ndi arginine (amino acid), zizindikiro zimakulanso. Mwa ana obadwa kwa amayi omwe ali ndi matenda ashuga, kubisalira kwa munthu amene ali ndi vuto la insulin nthawi zambiri kumayipa, komwe kungayambitse mapangidwe a neonatal hypoglycemia.

Kodi pituitary dwarfism ndi njira yothanirana ndikusowa kwa kukula kwa mahomoni opanga? Tili ndi yankho!

Werengani za momwe mungatengere Siofor ngati mankhwala ochiritsira a shuga 2 omwe alembedwa m'nkhaniyi.

Ntchito zolimbitsa thupi

Udindo waukulu ndikukwaniritsa kuchuluka kwa mahomoni a pancreatic komanso kuchuluka kwa glucose. Hyprogen ya polypeptide imalepheretsa insulin katulutsidwe, imalepheretsa kukula kwa hypo- ndi hyperglycemia.

Ntchito zina za glucagon m'thupi:

• kuwongolera kwa sodium zikuwonetsa, kuchotsa owonjezera kufufuza chinthu, matenda a mtima ndi mitsempha.
• imathandizira kufalikira kwa mafuta, kuchepetsa kuchuluka kwa mafuta m'thupi, kuchepetsa chiopsezo cha atherosulinosis,
• zolimbikitsa mphamvu ya maselo a chimbudzi cha insulin,
• imathandizira kuchira kwa hepatocytes,
• kutseguka kwa magazi kumayendedwe achilengedwe. Kuchepa kwa magazi kwa impso ndi chimodzi mwazomwe zimayambitsa kuwonongeka kwa nephron, kusokonezeka ndende, kusefera, endocrine ndi ntchito yopatsirana ziwalo zooneka ngati nyemba.

Homoni ya polypeptide imawonetsa zotsatira zofanana ndi zotsatira za adrenaline. Mochulukirapo, thupi likavomera kupsinjika, kuwonjezereka kwakukulu, ngoziyo imakulitsa kuchuluka kwa shuga pafupifupi nthawi yomweyo. Zotsatira - minofu imalandira nthawi yayitali chakudya komanso mphamvu kuti ichitike posachedwa ndi kuthamanga kwamphamvu kwa adrenaline.

Kodi kuwunika

Chizindikiro chachikulu ndi zizindikiro zomwe zikuwonetsa kukula kwa hypoglycemia. Potha kuchepa kwa shuga m'magazi, wodwalayo ayenera kuunikanso mahomoni apamba kuti amvetsetse momwe kupatukirako kumabisalira kwa owongolera ofunikira.

Zizindikiro zina:

• amaganiza kuti ali ndi matenda ashuga
• wodwala amachepetsa thupi popanda chifukwa chomveka
• mu njira yopangira chotupa,
• Ndi maonekedwe a zigawo zosunthira thupi.

Kukonzekera malamulo

Ndikofunikira kutsatira malamulo osavuta:

• tsiku loti mayeso asamamwe maswiti ambiri, osalimbikira ntchito, pewani kupsinjika,
• Pamaso kupendedwa masiku awiri, mowa amaletsedwa,
• mulingo woyenera pakati pa chakudya ndi magazi masampweya kuyambira 8 mpaka 10 maola. Ndi dontho lakuthwa kwambiri la shuga, muyenera kuchita maphunziro osachedwa kuti mudziwe momwe insulin ikutsutsirani,
• Pazosowa zizindikiro zowunikira mwadzidzidzi, muyenera kubwera ku labotale m'mawa, musanadye. Simungathe kumwa inunso, kuti musayambitse kupanga kwa chiwindi cha chiwindi.

Zifukwa zopatuka

Kusintha kwa katulutsidwe ka hormone ya pancreatic kumatengera zinthu zambiri. M'mikhalidwe yovuta kwambiri, osati adrenaline yokha, komanso kuchuluka kwa glucagon kumawonjezeka. Makhalidwe amasintha ndikusakhala ndi chakudya chopatsa thanzi, kumwa kwambiri mapuloteni (nthawi zambiri othamanga kapena amayi, kutsatira zakudya zina). Pali ma pathologies angapo omwe amawonongera magwiridwe antchito a kapamba ndi mahomoni oyambira.

Glucagon inachuluka

Kuchuluka kwambiri kwa mahomoni amadziwika motsutsana ndi matenda ndi zinthu zotsatirazi:

• khansa ya kapamba
• matenda ashuga
• kukula kwa hypoglycemia,
• Matenda a Cushing ndi matenda,
• kulephera kwa aimpso
• glucagonoma - chotupa cha ma alpha maselo a isanger a Langerhans,
• matenda a chiwindi
• kapamba

Miyezo ya mahomoni imachulukirachulukira pakapita nthawi opaleshoni, kuvulala, kuwotcha, kupsinjika, komanso kusokonezeka kwamaganizidwe. China chomwe chimapangitsa kudya kwambiri mapuloteni.

Momwe mungakhazikitsire magwiridwe antchito

Ndikofunikira kupenda zomwe zimapangitsa kuti pakhale katulutsidwe ka hormone ya pancreatic. Ngati mukuphwanya malamulo a zakudya, kukonda zakudya zama protein kapena kugwiritsa ntchito mapuloteni ambiri kumanga minofu, muyenera kusintha zakudya. Ndi shuga wotsika kwambiri, kuchuluka kwa mapuloteni kuyenera kuchulukitsidwa, ndi mitengo yamafupipafupi - yochepetsedwa.

Ngati chiwopsezo chowonjezeka cha wotsutsana ndi insulin chikugwirizana ndi kupsinjika kwamisala kapena kwamanjenje, ndikofunikira kusintha ntchito kapena kukhazikika kwa microclimate m'banjamo. Kupatuka kwakutalika kwa misempha ya glucagon kumakhudza insulin katulutsidwe, komwe kumatha kubweretsa kuchuluka kapena kuchepa kwa ndende ya glucose. Zinthu zonsezi (hyper- ndi hypoglycemia) ndizowopsa mthupi.

Ndi zizindikiro zowopsa za shuga (kutsika kwakanthawi), ndikofunikira kuyambitsa kupanga analogue ya glucagon yopanga munthawi. Pambuyo pa jakisoni, mkhalidwe wa wodwala umakhazikika, kuchuluka kwa shuga kumabweranso kwazonse. Ndikofunikira kuwunika momwe shuga amawerengera moyenera pazomwe zimachitika mu mahomoni a pancreatic.

Mukazindikira matenda omwe amakhudza osokoneza bongo a insulin, muyenera kukalandira chithandizo motsogozedwa ndi katswiri. Mu chotupa, nthawi zambiri, opaleshoni yochotsa mankhwalawa imafunikira. Njira za m'matumbo sizitha kuyambika m'mimba ndi m'matumbo: kuchepa kapena kuwonjezeka kwa munthu yemwe akumayambitsa matenda a insulin m'magazi am'magazi kumapangitsa kuti magazi azigaya.

Mukachira pakuwotcha ndi kuvulala, mitengo ya glucagon imabwezeretsa pang'onopang'ono. Ndikofunikira kuonetsetsa kuti wodwalayo akonzanso nkhawa kuti achepetse kusinthasintha kwa gawo la wotsutsana ndi insulin.

Dziwani zambiri zomwe zimayambitsa ma cysts oyenda m thupi mwa akazi komanso za mankhwalawa.

Zizindikiro za kukulitsa kwa thymus mwa ana ndi zosankha zamankhwala pazotsatira zam'mimba zimalembedwa patsamba lino.

Pitani ku http://vse-o-gormonah.com/vnutrennaja-sekretsija/shhitovidnaya/oftalmopatiya.html ndipo werengani za momwe mungagwiritsire endocrine ophthalmopathy ndikuletsa kutulutsa zovuta zowopsa.

Mapangidwe a glucagon wochizira matenda

Mankhwala a mahomoni amapangidwa pamtundu wa chinthu chomwe chimachokera m'matumba a ng'ombe ndi nkhumba. Popanga, glucagon wopezeka kuchokera ku nyama izi ndi wofanana ndi gawo la thupi. Mankhwala a mahomoni ndi jakisoni.

Ndi kuchepa kwambiri kwa ndende ya shuga (hypoglycemia), mkhalidwe wa wodwalayo umayenda bwino pakapita kanthawi kochepa kwambiri mu mnofu wambiri kapena mu mtsempha wa 1 ml ya glucagon. Muubwana, mankhwalawa amaloledwa kugwiritsidwa ntchito motsogozedwa ndi endocrinologist. Njira yabwino ndikugawa mulingo wovomerezeka mu ma jakisoni awiri kapena atatu, nthawi yayitali pakati pa jakisoni imachokera pa mphindi 10 mpaka 15. Pambuyo pobwezeretsanso kuchuluka kwa shuga, muyenera kudya ndi kumwa tiyi wokoma, ndiye kuti mupumule kwa ola limodzi ndi theka mpaka awiri. Pochiza matenda ena, muyezo wa analogue wopangidwa wa glucagon umatsimikiziridwa ndi adokotala.

Amayi oyembekezera amatha kupatsidwa mahomoni mwamphamvu monga akuwongolera ndi endocrinologist ngati mphamvu za shuga zatsika kwambiri. Ndikofunikira kusankha mulingo woyenera komanso nthawi yayitali ya chithandizo. Ndi kudya kwachilengedwe, mankhwalawa amaperekedwa pokhapokha ngati mwachitika zadzidzidzi. Pa mankhwala, ndikofunikira kuyamwitsa mwana kwakanthawi kwa bere.

Glucagon wa synthetic amagwiritsidwa ntchito ngati gawo la zovuta zovuta zama pathologies ambiri:

• shuga mellitus (ndi chitukuko cha hypoglycemia),
• spasms m'mimba ndi matumbo, kuphatikiza ndi pachimake diverticulitis,
• zotupa mu ndulu ndi ma ducts,
• matenda amisala (monga gawo la mankhwala a nkhawa).

Kupanga kwa glucagon kumawonetsa zotsatira zabwino pokonzekera odwala kuti ayesere matumbo am'munsi komanso apamwamba. Madokotala nthawi zambiri amagwiritsa ntchito mahomoni isanafike radiotherapy ndi radiology.

Mahomoni opanga sanatchulidwe:

• ndi chitukuko cha hyperglycemia,
• mwa ana aang'ono, kulemera kwam'mimba kotsika ndi 25 kg,
• ngati wodwala ali ndi chotupa cha adrenal chotupa - pheochromocytoma,
• ndi insulinoma,
• ndi chidwi ndi ntchito yogwira.

Dziwani zambiri za glucagon m'thupi lanu mutatha kuwona vidiyo yotsatirayi: