Glycated hemoglobin

1. Ma algorithms othandizira chithandizo chamankhwala kwa odwala omwe ali ndi matenda a shuga (5th edition). - Matenda a shuga, 2011, Na. 3, Zowonjezera 1, s, 4 - 72. http://dmjournal.ru/ru/articles/catalog/2011_3_suppl/2011_3_suppl.
2. Kugwiritsa ntchito Glycated Hemoglobin (HbA1c) mu Diagnosis of Diabetes Mellitus. World Health Organisation, 2011 http://www.who.int/diabetes/publications/report-hba1c_2011.pdf.
3. Miyezo Yabwino Kuchipatala ku Matenda a shuga - 2013. American Diabetes Association. - Disabetes Care, 2013, Vol. 36, Suppl. 1, S11-S66.

Kutanthauzira kwa zotsatira zakufufuzira kumakhala ndi chidziwitso kwa dotolo yemwe akupezekapo ndipo si matenda. Zambiri zomwe zili mgawoli sizingagwiritsidwe ntchito podzifufuza nokha. Dokotala amafufuza molondola pogwiritsa ntchito zotsatirazi polemba izi komanso chidziwitso chofunikira kuchokera kwazinthu zina: mbiri, zotsatira za mayeso ena, ndi zina zambiri.

Zipinda za INVITRO Independent Laboratorator:% ya hemoglobin yathunthu.

Kodi kusanthula kwa hemoglobin kukuwonetsa chiyani?

Pali mayeso osiyanasiyana kuti adziwe kuchuluka kwa hemoglobin m'magazi. Kuwunika kwa hemoglobin wa glycated: momwe angatenge? Musanayankhe funsoli, ndikofunikira kufotokoza tanthauzo la kusanthula kwake ndi chifukwa chake kuyenera kuli kofunikira.

Kodi kusanthula kwa hemoglobin kukuwonetsa chiyani?

Glycated kapena, mwa kuyankhula kwina, glycosylated hemoglobin ndi gawo limodzi lofunika la hemoglobin, lomwe limaphatikizana ndi glucose pakapita magazi. Ndi chizolowezi kuwerengetsa kuchuluka. Kuchuluka kwa shuga wokhazikika m'magazi, gawo lalikulu la hemoglobin lidzawonedwa ngati glycated. Kusanthula uku kuyenera kuchitika kuti kuwunikire zikuwonetsa za matenda obwera chifukwa cha matenda ashuga kapena ngati pakukayikira anthu odwala matenda ashuga. Kuwunikaku kukudziwitsani ngati pali matenda kapena ayi.

Kusanthula kumawonetsa kuchuluka kwa shuga m'magazi m'miyezi itatu yapitayo.

Kuchuluka kwa hemoglobin ya glycated imawonedwa ngati chisonyezo cha metabolism ya carbohydrate panthawi yodziwikiratu. Glycated hemoglobin imayamba kukhala yabwinobwino sabata lachinayi mpaka lachisanu ndi chimodzi itatha kuchuluka kwa glucose m'magazi. Mlingo wa gulu lotere m'magazi a anthu odwala matenda ashuga limatha kukhala kawiri kapena katatu poyerekeza ndi chizolowezi.

Odwala odwala matenda ashuga ayenera kuyesedwa kamodzi pa kotala. Ndikofunika kuchita ukazolowere mu labotale yofananira, chifukwa mwanjira zina zotsatira zimatha kusiyanasiyana.

Kusanthula kumeneku kuli ndi ubwino wake. Mapindu awa amatsimikizidwa mukayerekezera ndi mayeso osala othamanga a shuga ndi mayeso okhalitsa a shuga a maola awiri. Amaimiridwa ndi:

1. Kuchita mwachangu komanso kolondola poyerekeza ndi kusanthula kwina,
2. Zotsatira zomaliza zowunikirazi sizikhudzidwa ndi kuzizira kwa wodwalayo kapena kuwonekera kwake pazochitika zopsinjika,
3. Kusanthula kumakupatsani mwayi kuti muwone ngati munthu ali ndi matenda a shuga kapena ayi,
4. Kusanthula koteroko sikofunikira kuti pakhale pamimba yopanda kanthu, sizofunikira kwambiri.

Kuphatikiza apo, kuwunika kotereku kumatha kuchitika ngakhale munthu atamwa mowa, ndipo izi sizingakhudze zotsatira zomaliza.

Zotsatira za kusanthula kumeneku sizikutengera kulimba thupi komwe munthu adachita asanadzipereka, mkhalidwe wake wamaganizo, kapena kumwa mankhwala. Koma kupatula apa padzakhala mankhwala osokoneza bongo.

Kuyesedwa kwa magazi kwa hemoglobin ya glycated: kukonzekera bwanji?

Si onse omwe akuwunika amafunika kukonzekera, koma izi zikugwira ntchito kwa ambiri. Glycated hemoglobin: kukonzekera kusanthula - ziyenera kuyenda bwanji? Ngakhale kuti pamakhala zambiri sikofunikira kukonzekera kusanthula mosamala monga ena, munthu ayenera kutsatira zomwe tafotokozazi pansipa.

1. Maola asanu musanadye biomaterial sikulimbikitsidwa kudya. Ndikofunika komabe kuti mupange mpanda pamimba yopanda kanthu ndikukana tiyi ndi koloko musanadutse mayeso.
2. Chifukwa magazi amachokera m'mitsempha, anthu ena amatha kumva kuti ali ndi chizungulire kapena osuwa. Pazifukwa izi, ndikofunikira kuchenjeza akatswiriwo kuti zotere zitha kuchitika kuti adakonzera ammonia,
3. Ntchito yantchito, kuchepa kwambiri kwa magazi dzulo lake komanso kusamba kolemera, komwe kunachitika patatsala pang'ono kuyesedwa, kumatha kupotoza zotsatira zomaliza za kusanthula.

Magazi amayesedwa pafupifupi masiku atatu kuchokera pomwe wodwalayo adapereka.

Kusintha kwa kusanthula: glycated hemoglobin

Kuyesedwa kwa magazi kwa shuga (glycated hemoglobin): zolembedwa - ndi chiyani? Pansipa tidzawonetsedwa peresenti ndi zotsatila zake:

1. Pansi pa gawo la 5.7 peresenti. Poterepa, titha kunena kuti munthu alibe matenda ashuga ndipo kuupeza kwake ndikochepa. Mphamvu ya kagayidwe kakang'ono ka wodwala imakhala yachilendo,
2. 5.7 mpaka 6 peresenti. Zomwezi zimawonetsa kuti shuga siyokhazikika, koma chiwopsezo cha kukula kwake chikuchulukitsidwa. Popewa, kufunika kosinthira ku chakudya chochepa chamafuta. Muyenera kuphunzira zambiri zokhudzana ndi metabolic syndrome ndi kukana insulin,
3. Kuchokera pa 6.1 mpaka 6.4 peresenti. Pankhaniyi, chiwopsezo cha wodwala kukhala ndi matenda a shuga chikuwonjezeka. Tikufuna kusintha kosinthika kukhala ndi moyo wathanzi komanso zakudya zamafuta ochepa. Komanso, zosintha zoterezi sizingachitike pambuyo pake,
4. Oposa 6.5 peresenti. M'mbuyomu, adokotala amazindikira matenda ashuga. Kuti mutsimikizire kapena kutsutsa molondola izi, kuyesa kwina kumayikidwa.

Kuyesedwa kwa magazi kwa hemoglobin ya glycated: decoding - ndi chiyani china chomwe chingadziwike? Ngakhale kuti malangizo omwe ali pamwambawa anaperekedwa, omwe akuyenera kuwongolera pakulemba, ndibwino kuperekera nkhaniyi kwa dokotala wodziwa, yemwe afotokozere zomwe wodwalayo adakumana nazo.

Glycated hemoglobin: kodi kuyesa kumawononga ndalama zingati?

Zachidziwikire, mtengo wa kusanthula kotere ungasiyane kwambiri ndipo zimatengera pomwe wodwalayo amapitiradi kusanthula uku. Glycated hemoglobin: mtengo wa kusanthula - ndi chiyani, ngati mukuyang'ana pafupifupi? Ngati mukuyang'ana mitengo yomwe ilipo mu labotale yachipatala ya Invitro, mtengo wamba pali ma ruble 6330, kuphatikiza ma ruble 200 otenga magazi kuchokera mu mtsempha, muyenera kuwonjezera pa mtengo.

Kayezetsa magazi a glycated hemoglobin? Izi zitha kuchitika mu maofesi azachipatala azokha, zipatala, ma labotale, kapena mutha kupita ndi dokotala yemwe ali ndi wodwalayo ndikupita naye kuchipatala cha boma, kumene kuwunika kumeneku ndi kwaulere. Wodwala aliyense amasankha yekha. Mu chipatala chachinsinsi, ntchito idzakhala yapamwamba, zomwezo zitha kunenedwa ponena za nthawi yowunikira.

Kuphatikiza apo, ndikofunikanso kutchulanso kuti magazi pazisonyezero zotere ayenera kuperekedwanso kwa amayi apakati. Komabe, zovuta zina zingabuke apa. Chowonadi ndi chakuti thupi la mkazi limasinthasintha mosinthana ndi zomwe zimachitika mwa iye, ndichifukwa chake kusintha kwa hemoglobin wa glycated kumatheka. Kusiyana kumeneku kungakhalenso chifukwa chazovuta, mwachitsanzo, kuwonongeka kwa impso, kuchepa kwa mawonekedwe, kuwonongera kwamitsempha yamagazi yamagazi, kuwonjezeka kowopsa kwa kulemera kwa mwana wosabadwayo m'mimba mwa amayi, komwe kumatha kufika ma kilogalamu asanu.

Mbali yakuwunika kwa hemoglobin ya glycated: mtengo wa chipatala chonse cha boma komanso ma labotale achinsinsi monga Invitro, Hemotest, Helix ndi Sinevo

Glycohemoglobin ndi chizindikiro cha zamankhwala am'madzi zomwe zimatha kuwonetsa kuchuluka kwa shuga m'matumbo nthawi yayitali (mpaka masiku 90).

Amayeza ngati peresenti. Mokulirapo kuchuluka kwa glucose, kumapangitsa chidwi cha kuchuluka kwamankhwala amitundu mitundu.

Ngati pali kukayikira kochepa mu kapamba, ndiye kuti kuwunika kwa hemoglobin wa glycated ndikofunikira kwambiri. Zimakuthandizani kuzindikira matenda ashuga munthawi yake.

Hemoglobin ndi gawo la mapuloteni m'maselo ofiira a m'magazi. Ntchito yayikulu ya chinthuchi ndikuyenda mwachangu kwa okosijeni kuchokera ku kupuma kupita ku ziwalo zathupi.

Komanso kuperekanso mpweya woipa kuchokera kwa iwo kubwerera kumapapu. Molekyu ya hemoglobin imapangitsa kukhalabe ndi mawonekedwe abwinobwino a maselo amwazi.

Poyesedwa:

1. ngati pali zokayikitsa za matenda ashuga, zomwe zimayambitsidwa ndi zizindikiritso izi: ludzu ndi kuuma kwa zilonda zamkati, kununkhira kwa maswiti kuchokera mkamwa, kukoka pafupipafupi, kudya kwambiri, kutopa, kusawona bwino, kuchiritsa pang'onopang'ono mabala, komwe kumachitika motsutsana ndi maziko a kuchepa kwa ntchito yoteteza thupi.
2. pomwe pali kulemera kwambiri. Anthu omwe alibe ntchito, komanso anthu oopsa omwe ali pachiwopsezo amakhala pachiwopsezo. Ayenera kukayezetsa magazi,
3. cholesterol yotsika:
4. mayiyo anapezeka kuti ali ndi ovary ya polycystic,
5. kuyesako kumawonetsedwa kwa anthu omwe abale awo apamtima anali ndi matenda amtima komanso ozungulira;
6. kusanthula kuyenera kuchitika m'njira zina zokhudzana ndi kukana kwa mahomoni a kapamba.

Kampani yotchuka yotchedwa Invitro imapereka mwayi wopanga mawunikidwe ake ndikutola zotsatira zomaliza mu maola awiri.

M'matawuni ang'onoang'ono ndizovuta kupeza chipatala chabwino. M'mabotolo ang'onoang'ono, amatha kupereka mayeso am'magazi amitundu iwiri, yomwe mtengo wake umakhala wokwera kwambiri, ndipo zitha kuchitika pamimba yopanda kanthu.

Glycosylated hemoglobin ndi imodzi mwazomwe zimapangira glycemia, wopangidwa ndi enzymatic glycation.

Pali mitundu itatu yamtunduwu: HbA1a, HbA1b ndi HbA1c. Ndiwo mtundu wotsiriza womwe umapangidwa modabwitsa.

Pankhani ya hyperglycemia (kuchuluka kwa kuchuluka kwa glucose), gawo la hemoglobin la glycated limakulanso malinga ndi kuchuluka kwa shuga. Ndi mtundu wowerengeka wa matenda ashuga, zomwe zimapezeka mumtengo zimafikira mtengo wopitilira muyeso katatu kapena kuposerapo.

Monga lamulo, kuwunikiridwa kwa Territorial Program of State Guaranteed pakupereka chithandizo chamankhwala kwa anthu kwaulere. Amachitidwa molunjika ndi adotolo kuti apatsidwe patsogolo.

Mtengo wowunikira umasiyanasiyana kuchoka pa 590 mpaka 1100 rubles, kutengera malo ndi gulu la chipatala chawekha.

Tiyenera kudziwa kuti mtengo woyeserera wamagazi am'magazi (mbiri yayitali), poyerekeza, umachokera ku ma ruble 2500.

Magazi a hemoglobin ya glycosylated amaperekedwa modabwitsa chifukwa choti mtengo wa kuwunikirako ndiwokwera kwambiri. Zotsatira za phunziroli zitha kuwonongeka ndi zochitika zilizonse zomwe zimakhudza nthawi yayitali yamagazi. Izi zimaphatikizapo kutaya magazi, komanso kuthira magazi.

Pofotokoza zotsatira zake, katswiriyo amakakamizika kuganizira zonse zomwe zingakhudze zomwe zatsimikizidwazo pakuzindikira. Ku chipatala cha Invitro, mtengo wa kafukufukuyu ndi ma ruble 600. Zotsatira zomaliza zitha kupezeka mu maola awiri.

Mtengo wake pachipatalachi ndi ma ruble 420. Tsiku lomaliza la kusanthula ndi tsiku limodzi.

Muthanso kuyesedwa magazi ku Helix Lab. Nthawi yophunzira biomaterial mu labotale iyi imakhala mpaka masana tsiku lotsatira.

Ngati kuwunikiridwa kumaperekedwa asanafike maola khumi ndi awiri, zotsatira zake zitha kupezeka mpaka maola makumi awiri ndi anayi tsiku lomwelo. Mtengo wa kafukufukuyu pachipatalachi ndi ma ruble 740. Mutha kupeza kuchotsera mpaka ma ruble 74.

Hemotest Medical Laboratory ndiyotchuka kwambiri. Kuchititsa phunziroli, zinthu zachilengedwe zimagwiritsidwa ntchito - magazi athunthu.

Mu chipatala chino, mtengo wa kuwunikirako ndi ma ruble 630. Kumbukirani kuti kutenga zotsalira kumalipidwa mosiyana. Pamsonkha magazi a venous azilipira ma ruble 200.

Musanapite kuchipatala, muyenera kukonzekera kaye. Zachilengedwe zimayenera kutengedwa m'mawa kuyambira eyiti mpaka leveni koloko.

Magazi amangoperekedwa pamimba yopanda kanthu. Pakati pa chakudya chomaliza ndi zitsanzo za magazi, ayenera kudutsa maola eyiti.

Madzulo aulendo wopita ku labotale, chakudya chamadzulo chocheperako chimaloledwa kupatula zakudya zamafuta. Musanachite kafukufukuyu, ndikofunikira kuti musamamwe mowa ndi mankhwala osokoneza bongo.

Kutatsala maola awiri kuti mupereke magazi, muyenera kupewa kusuta, msuzi, tiyi, khofi ndi zakumwa zina zokhala ndi khofi. Amaloledwa kumwa madzi osayengedwa okha osakhala ndi kaboni muyeso wopanda malire.

Zambiri pazokhudza kuyesa kwa magazi a glycated hemoglobin mu kanema:

Kuyesedwa kwa magazi kumapangitsa kuti azindikire panthawi yake zovuta za metabolism. Ndi boma la matenda ashuga asanakwane, phunziroli lithandiza kupewa matenda owopsa.

Chifukwa chake, ndizotheka kuchepetsa matendawa ndikukhalanso ndi shuga pamlingo woyenera. Chobwereza chokha cha kusanthula ndi mtengo wokwera. Pachifukwa ichi, amalembedwa mosalekeza.

• Imakhazikika pamisempha ya shuga kwa nthawi yayitali
• Zimabwezeretsa kupanga kwa insulin

Phunzirani zambiri. Osati mankhwala. ->

Glycated (glycosylated) hemoglobin Ndi mtundu wa hemoglobin chifukwa chokhudzana ndi shuga. Glycated hemoglobin imanyezimiritsa kuchuluka kwa magazizomwe zidachitika utali wonse wam'magazi ofiira (mpaka masiku 120). Maselo ofiira omwe amayenderera m'magazi amakhala ndi mibadwo yosiyana, motero amayang'ana nthawi yayitali ya masiku 60.

Chiyeso chachipatalachi chimagwiritsidwa ntchito kwambiri poyeza kuchuluka kwa chiphuphu cha matenda a shuga:

• kuchuluka kwa hemoglobin ya glycated m'malo osiyanasiyana a 4-6% kumawonetsa chiphuphu chabwino cha matenda ashuga m'miyezi 1-1,5 yapitayo,
• 6-8.9% - pafupi kuphatikiza matendawa,
• oposa 9% - pakuwongolera ndi kufunika kosintha mankhwala antidiabetes.

Ndikothekanso kugwiritsa ntchito zomwe tafotokozazo zasayansi yofufuzira matenda oyamba amitundu yosiyanasiyana ya matenda ashuga. Kuchepetsa kuchuluka kwa hemoglobin ya glycated ndikotheka ngati wodwala ali ndi hemolytic anemia (erythrocyte moyo amafupikitsidwa), hemorrhages yovuta kwambiri komanso yotupa.

Zachilengedwe: magazi athunthu

Satifiketi ya njira yoyenera yokhazikitsira "Glycated hemoglobin HbA1" (National Glycohemoglobin Standardizatin Program, NGSP):

Satifiketi ya International Federation of Clinical Chemistry IFCC (International Federation of Clinical Chemistry) "Glycated hemoglobin HbA1":

MALANGIZO OGWIRITSIRA NTCHITO KUKonzekera:

1. Mwa maphunziro ambiri, tikulimbikitsidwa kupereka magazi m'mawa, kuyambira maola 8 mpaka 11, pamimba yopanda kanthu (pafupifupi maola 8 ayenera kumatsika pakati pa chakudya chomaliza ndi zitsanzo zamagazi, madzi atha kumwa monga mwa nthawi zonse), tsiku lomaliza la phunzirolo, chakudya chamadzulo chopepuka kudya zakudya zamafuta. Poyetsa matenda ndi matenda opatsirana mwadzidzidzi, ndizololeka kupereka magazi patatha maola 4-6 chakudya chatha.

2. CHIYAMBI! Malamulo apadera okonzekera mayeso angapo: mosamala pamimba yopanda kanthu, pambuyo pa maola 12-16 osala kudya, magazi ayenera kuperekedwa kwa gastrin-17, lipid mbiri (cholesterol yathunthu, cholesterol ya LDL, cholesterol ya LDL, VPLL cholesterol, triglycerides, lipoprotein (a), apolipoprotein A1, apolipoprotein B), kuyesa kwa glucose kumachitika m'mawa m'mimba yopanda kanthu pambuyo pa maola 12-16 osala kudya.

3. Madzulo a kafukufukuyu (mkati mwa maola 24) kuti musamamwe mowa, kuchita masewera olimbitsa thupi kwambiri, kumwa mankhwala (monga momwe adavomerezera ndi adotolo).

4. Kwa maola 1-2 musanapereke magazi, pewani kusuta, osamwa juwisi, tiyi, khofi, mutha kumwa madzi.Pewani kupsinjika kwakuthupi (kuthamanga, kukwera masitepe mwachangu), mwamphamvu. Mphindi 15 asanapereke magazi, tikulimbikitsidwa kuti mupumule.

5. Musapereke magazi kuti mupeze kafukufuku wa zasayansi mukangopeza njira zochitira masewera olimbitsa thupi, kuwunika mozama, maphunziro a x-ray ndi ultrasound, kutikita minofu ndi njira zina zamankhwala.

6. Mukamayang'anira magawo a Laborator mu mphamvu, ndikulimbikitsidwa kuchititsa maphunziro obwerezabwereza pansi pazomwezi - mu labotale yomweyo, perekani magazi nthawi yomweyo.

7. Magazi ofufuzira ayenera kuperekedwa asanamwe mankhwala kapena osapitirira masiku 10 mpaka 14 atachotsedwa. Kuti muwone kuyendetsa bwino kwa chithandizo cha mankhwala ndi mankhwala aliwonse, kafukufuku ayenera kuchitidwa patadutsa masiku 7 mpaka 14 atatha kumwa kotsiriza.

1. Kusuta, kumwa, kudya, kuchita masewera olimbitsa thupi nthawi yayitali,
2. Matenda aposachedwa, opaleshoni kapena vuto lililonse.

Chulukitsani Mfundo:
1. matenda a shuga ndi zina zomwe zimalekerera shuga,
2. kuchulukitsa konyenga ndi kuchepa kwa magazi m'thupi, kuchepa kwa magazi m'thupi
Sinthani mumalingaliro:
1. hypoglycemia,
2. kunamizidwa kopusitsa ndi hemolytic anemia, utatuluka magazi, kuthira magazi.

Mapuloteni a hemoglobin amapezeka m'maselo ofiira a m'magazi. Amachititsa kuti mpweya wabwino ubweretse ziwalo zamkati. Pali magawo angapo a puloteni iyi. Mtundu wofala kwambiri ndi hemoglobin A. Chimodzi mwa zinthu zake ndi Hemoglobin A1c. Pokonza shuga kudzera m'thupi, gawo la hemoglobin limasinthidwa kukhala HbA1c chifukwa cha glycation reaction (glucose kuwonjezera). Mlingo wa chinthu ichi umatengera kuchuluka kwa shuga. Phata silikuwola moyo wonse wamaselo ofiira a magazi. Nthawi imeneyi ndi pafupifupi miyezi itatu. Kapangidwe kamapangidwe kameneka ndi kutha kwa magazi kumachitika mosalekeza, monga momwe maselo ofiira amwazi amapangidwira.

Kusantikako kumagwiritsidwa ntchito kuwunika momwe odwala ali ndi matenda ashuga. Malinga ndi zotsatira zake, adokotala amatha kuwunika momwe mankhwalawo amathandizira. Ngati kafukufuku akuwonetsa kuti chithandizo sichimapereka zotsatira, dokotala amatha kusintha njira zake mwachangu. Kuphatikiza apo, kwa anthu omwe ali ndi matenda ashuga, kuwongolera shuga ndikofunikira kwambiri. Zimakupatsani mwayi wochepetsera zovuta za matendawa, kukhala wathanzi komanso moyo wautali. Kwa odwala omwe apezeka posachedwa, kafukufuku amapatsidwa kuti awone kuchuluka kosalamulira kwa glucose. Kuwunikira kumatha kulembedwa panthawi yoyeserera kuti mudziwe matendawa kumayambiriro, koma maphunziro owonjezera nthawi zambiri amafunikira kuti adziwe kuti ali ndi matendawo.

Magazi amatengedwa pamimba yopanda kanthu (osachepera 8 ndipo osaposa maola 14 akusala). Mutha kumwa madzi opanda mpweya.

Kafukufukuyu amatsimikiza kuchuluka kwa Hemoglobin A1c m'magazi a venous. Zotsatira za kuwunikaku zimapangitsa kudziwa kuchuluka kwa glucose pakapita miyezi pafupifupi itatu. Thupi, kuchuluka kwake komwe kumatsimikiziridwa pakuwunikaku, ndi zovuta za mamolekyulu a hemoglobin ndi glucose. Kutanthauzira pazotsatira za phunziroli kungachitike kokha ndi dokotala.

Zizindikiro zakusanthula

Nthawi zambiri, amafufuza ngati mukuganiza kuti wodwala ali ndi matenda ashuga. Zizindikiro za matendawa zimaphatikizapo mawonetsedwe otsatirawa: ludzu lochulukirapo, kusachedwa kuwonekera, komwe ndi lakuthwa, kutopa, matenda opatsirana pafupipafupi.

Komanso, kuyesedwa kwa glycosylated hemoglobin kumachitika nthawi zonse kwa odwala omwe ali ndi matenda osokoneza bongo (pankhani ya matenda omwe adakhazikitsidwa kale). Nthawi zambiri, nthawi yayitali pakati pa mayeso ndi miyezi 3-6, koma poganizira momwe wodwalayo alili ndi chithandizo, dokotala atha kukufotokozerani pafupipafupi maphunziro.

Zotsatira za kuyesedwa kwa labotale sindizo zokhazo zomwe madokotala omwe amapezekapo amawaganizira popanga chithandizo ndikupereka mankhwala oyenera, ndipo akuyenera kuwonedwa molumikizana ndi anamnesis ndi zotsatira za mayeso ena otheka, kuphatikizapo njira zodziwira matenda.
Ku LabQuest Medical Company, mutha kulumikizana ndi dotolo wa Doctor Q malinga ndi zotsatira za maphunziro mukakonzekera kapena patelefoni.

Glycated hemoglobin amagwira ntchito yofunika kwambiri pakuwonetsa matenda a shuga. Chifukwa cha iye, mutha kuzindikira matendawa m'mayambiriro ake. Izi zimapangitsa kuti ayambe kulandira chithandizo munthawi yake.

Mulingo wa chizindikirochi umayang'aniridwa kuti muwone kuyendetsa bwino ntchito. Koma ndi anthu ochepa okha omwe amadziwa kuti ndi chiyani.

Hemoglobin ndi gawo limodzi lama cell ofiira a m'magazi - magazi m'magazi omwe ali ndi vuto lonyamula mpweya ndi kaboni dayokisi. Shuga ikadutsa membrane wa erythrocyte, zimachitika. Amino acid ndi shuga zimayenderana. Zotsatira zake zimachitika ndi glycated hemoglobin.

Hemoglobin imakhala yokhazikika mkati mwa maselo ofiira a m'magazi, chifukwa chake, mlingo wa chizindikirochi umakhala wokhazikika kwa nthawi yayitali (mpaka masiku 120). Kwa miyezi 4, maselo ofiira amagwira ntchito yawo. Pambuyo pa nthawi imeneyi, amawonongedwa ndi zamkati zofiira za ndulu. Pamodzi ndi iwo, njira yowonongeka imadutsa glycohemoglobin ndi mawonekedwe ake aulere. Pambuyo pake, bilirubin (mankhwala omaliza a kuphwanya kwa hemoglobin) ndi glucose samamanga.

Fomu ya glycosylated ndichizindikiro chofunikira kwa odwala omwe ali ndi matenda ashuga komanso mwa anthu athanzi. Kusiyanako kumangokhala pakungoganiza.

Pali mitundu ingapo ya hemoglobin ya glycated:

Muzochita zachipatala, mtundu wotsiriza umapezeka kwambiri. Njira yolondola ya kagayidwe kazakudya ndi zomwe glycated hemoglobin imawonetsa. Kuphatikiza kwake kumakhala kokwanira ngati mulingo wa shuga ndiwopamwamba kuposa wabwinobwino

Mtengo wa HbA1c amayeza ngati peresenti. Chizindikirochi chimawerengedwa ngati gawo la kuchuluka kwa hemoglobin voliyumu.

Kuyesedwa kwa magazi kwa hemoglobin ya glycated ndikofunikira ngati mukukayikira matenda ashuga ndikuwunika momwe thupi limayankhira chithandizo cha matenda. Amanena zolondola. Mwa kuchuluka kwa kuchuluka, mutha kuweruza shuga m'magazi atatu apitawa.

Endocrinologists amagwiritsa ntchito bwino chizindikiro ichi pakupezeka mitundu ya matenda am'mbuyomu, pakakhala kuti palibe chizindikiro chodziwika bwino cha matendawa.

Chizindikirochi chimagwiritsidwanso ntchito ngati chikhomo chomwe chimazindikiritsa anthu omwe ali pachiwopsezo chotenga zovuta za matenda ashuga. Gome limawonetsa zizindikiritso zam'magulu azaka, zomwe akatswiri amatsogolera.

Kuthekera kwa kukhala ndi hypoglycemia (kuchepa kwa shuga) mu shuga

Mayeso wamba amatayika kwambiri motsutsana ndi kumbuyo kwake. Kusanthula pa HbA1c ndizopindulitsa komanso zosavuta.

Mkazi aliyense ayenera kulabadira kuchuluka kwa hemoglobin wa glycated m'thupi. Kupatuka kwakukulu pazikhalidwe zovomerezeka (tebulo pansipa) - zikuwonetsa zolephera izi:

1. Matenda a matenda osiyanasiyana.
2. Kusowa kwazitsulo.
3. Kulephera kwina.
4. Makoma ofooka amitsempha yamagazi.
5. Zotsatira za opareshoni.

Zomwe zimachitika mwa akazi zizikhala mu izi:

Ngati kusiyanasiyana kwapezeka pazomwe zikuwonetsedwa, ndikofunikira kuyesedwa, komwe kungathandize kudziwa zomwe zimayambitsa kusintha kwa shuga.

Mwa amuna, chiwerengerochi ndi chachikulu kuposa chachikazi. Zomwe zimachitika m'badwo zimasonyezedwa patebulo:

Mosiyana ndi amayi, oimira ogonana amphamvu, phunziroli liyenera kuchitidwa pafupipafupi. Izi ndizowona makamaka kwa amuna opitilira 40.

Kulemera msanga kungatanthauze kuti munthu wayamba kudwala matenda ashuga. Kutembenukira kwa katswiri pazizindikiro zoyambirira kumathandizira kuzindikira matendawa m'magawo oyambira, zomwe zikutanthauza chithandizo chanthawi yake komanso chothandiza.

Mu mwana wathanzi, kuchuluka kwa "shuga pawiri" ndikofanana ndi kwa munthu wamkulu: 4.5-6%. Ngati matenda a shuga adapezeka ali ana, ndiye kuti kuwongolera mosamalitsa pakutsatira ndi zomwe zikuchitika kumachitika. Chifukwa chake, ana omwe ali ndi matendawa popanda chiopsezo cha zovuta ndi 6.5% (7.2 mmol / l glucose). Chizindikiro cha 7% chimawonetsera kukhala ndi hypoglycemia.

Mwa odwala matenda ashuga achinyamata, chithunzi chonse cha matendawa chitha kubisika. Izi zitha kuchitika ngati adapereka kuwunika m'mawa pamimba yopanda kanthu.

Pa nthawi yomwe mayi ali ndi pakati, thupi la mkazi limasintha. Izi zimakhudzanso milingo ya shuga. Chifukwa chake, zomwe zimachitika nthawi ya pakati mwa mayi ndi zosiyana pang'ono ndi momwe zimakhalira:

1. Paubwana, ndi 6.5%.
2. Wapakatikati amafanana ndi 7%.
3. Mwa amayi apakati "okalamba", mtengo wake uyenera kukhala osachepera 7.5%.

Glycated hemoglobin, momwe zimakhalira nthawi yoyembekezera iyenera kuwunika miyezi 1.5 iliyonse. Popeza kusanthula uku kumatsimikizira momwe mwana wamtsogolo adzakhalire ndi kumva. Kupatuka pamalingaliro kumakhudza kwambiri mkhalidwe wa "puzozhitel" wokha, komanso amayi ake:

• Chizindikiro pansipa chimakhala chofanana ndi mulingo wachitsulo ndipo chingayambitse kulepheretsa chitukuko cha fetal. Muyenera kuwunikiranso momwe mumakhalira, idyani zipatso ndi masamba ambiri.
• Mulingo wambiri wa "shuga" hemoglobin umawonetsa kuti mwana akhoza kukhala wamkulu (kuchokera ku makilogalamu 4). Chifukwa chake, kubadwa kudzakhala kovuta.

Mulimonsemo, kuti muwongolere zolondola, muyenera kufunsa dokotala.

Kuwunikira kwa hemoglobin ya glycated amaperekedwa pakuwunika, pomwe wodwalayo amadziwa kale za matenda ake. Cholinga cha phunziroli:

• Magazi a shuga.
• Kukonza Mlingo wa mankhwala ochepetsa shuga.

Chikhalidwe cha matenda ashuga chimakhala pafupifupi 8%. Kusungabe gawo lalitali chonchi kumachitika chifukwa cha kuzolowera thupi. Ngati chizindikirocho chikugwa kwambiri, izi zimayambitsa chitukuko cha dziko la hypoglycemic. Izi ndizowona makamaka kwa anthu okalamba. Mbadwo wachichepere uyenera kuyesetsa kwa 6.5%, izi zimathandiza kupewa zovuta.

Gulu lazaka zapakatikati (%)

Ukalamba ndi chiyembekezo cha moyo. Views: 176368

Kukonzekera kwa kusanthula

Maola 24 amaika zakudya zamafuta ndi okazinga, kupatula mowa ndi kulimbitsa thupi, komanso radiology, fluorography, ultrasound ndi physiotherapy.

Kuyambira maola 8 mpaka 14 magazi asanapereke magazi, muzimwa madzi oyera okha.

Kambiranani ndi dokotala zamankhwala omwe mumamwa komanso zomwe amachokera.

Kutanthauzira kwa zotsatira za kafukufukuyu "Glycated hemoglobin (glycosylated, glycogemoglobin, hemoglobin A1c, HbA1c, glycated hemoglobin, hemoglobin A1c)"

Yang'anani! Kutanthauzira kwa zotsatira za mayeso ndicholinga chodziwikiratu, sikukuwonetsa ngati matenda ndipo sikulowa m'malo mwa kufunsa kwa dotolo. Mitengo yolozera imatha kusiyanasiyana ndi zomwe zikuwonetsedwa malinga ndi zida zomwe zikugwiritsidwa ntchito, zenizeni zikuwonetsedwa pafomu yazotsatira.

Gulu lofufuzira lidachita maphunziro a DCCT, omwe adawonetsa bwino kufunikira kwa HbA1c monga kuyerekezera kwapakati pa glucose wamagazi (masiku 60 - 90). Kamangidwe ka maphunzirowa anali motere: mbiri ya tsiku ndi tsiku ya glucose imatengedwa kuchokera kwa odwala miyezi itatu iliyonse (miyezo isanu ndi iwiri tsiku lililonse) kenako ndikufanizira ndi mulingo wa HbA1c. Pa zaka 9, maphunziro oposa 36,000 adachitidwa.

Akuluakulu a shuga glucose (mmol / L) = HbA1cx 1.59-2.59, komwe:

HbA1c ndi kuchuluka kwa hemoglobin wa glycated.

Mwachidule, kusintha kwa 1% mu HbA1c kumafanana ndi kusintha kwa glucose wapakati pa 1.59 mmol / L. Chidziwitso: Ubale uwu unapezeka pofufuza kuchuluka kwa shuga m'magazi a capillary.
Tchati chitha kugwiritsidwa ntchito kutanthauzira zotsatira za maphunziro a HbA1c.

Mkuyu. 1. Chithunzi cha kuwongolera kwa kagayidwe kazakudya kwa odwala matenda a shuga.

Chidziwitso: Kuzungulira kwa glucose kumawonetsedwa mu mmol / l, mu mabere mg mg / 100 ml, 1 - Chiwopsezo chachikulu chotenga zovuta zazitali, monga retinopathy, nephropathy ndi neuropathy. 2 - Chiwopsezo chowonjezeka cha zotsatira za hypoglycemic kwa odwala omwe ali ndi matenda amtundu wa 1 kapena 2 omwe ali ndi insulin kapena mankhwala a hypoglycemic.

American Diabetes Association (1999) yalimbikitsa kuyesa odwala omwe chithandizo chawo chakhala chikuyenda bwino (shuga m'magazi) pa HbA1c osachepera 2 pachaka, ndipo ngati zakudya kapena chithandizo chasinthidwa, onjezani kuchuluka kwa mayeso mpaka maulendo 4 chaka. Ku Russia, molingana ndi Federal Target Program "Shuga Mellitus," tikulimbikitsidwa kuti kafukufuku wa HbA1c odwala omwe ali ndi matenda osokoneza bongo azichitika kangapo kamodzi pa kotala lililonse la matenda ashuga.

Njira yapadera yowunikira ikulimbikitsidwa ndi American Diabetes Association (1999) kwa amayi omwe ali ndi matenda ashuga pamene akukonzekera kutenga pakati. Mlingo wa HbA1c uyenera kuchepetsedwa kuti apange machitidwe oyenera kuti mwana akhale ndi pakati komanso kubereka M'mimba yoyambirira, HbA1c iyenera kuyang'aniridwa kamodzi pamwezi. Atafika pamlingo wokwanira wamagazi m'magazi, chifukwa cha mankhwala oyenera, kuphunzira kwa HbA1c kuyenera kuchitidwa pakadutsa masabata 6 mpaka 8 asanamwali.

Kafukufuku wamakono adawonetsa kuti nthawi zambiri odwala samatsatira mayeso omwe amayesedwa, komabe, akatswiri akuti chiwopsezo cha zovuta za odwala omwe ali ndi matenda osokoneza bongo amachepetsa kwambiri ndi mayeso pafupipafupi pazomwe zili ndi HbA1c. Cholinga chochepetsa shuga kwa odwala matenda ashuga ndi kuchepetsa kuchuluka kwa shuga m'magazi. Kafukufuku mu kapangidwe ka DCCT (DCCT Research Group, 1993) adawonetsa kuti ndi chithandizo champhamvu, chiwopsezo cha zovuta zazitali monga neuropathy, nephropathy, retinopathy zimachepetsedwa kwambiri, kapena kuwonetsedwa kwawo kwakanthawi. Odwala ayenera kutsatira mosamalitsa njira yokhazikitsidwa ndi kagayidwe kazakudya, ndiye kuti matenda a nephropathy ndi 35-6%, chiwopsezo cha polyneuropathies ndi retinopathies chimachepetsedwa ndi 75%.

Otsatirawa ndi mndandanda wazolinga zochizira matenda a shuga malinga ndi Federal Targeted Diabetes Program.

Gome 1. Zolinga zakuchizira pochiza matenda amishuga 1.

Kudziyang'anira wekha wamagazi, mmol / l (mg%)

Patatha maola awiri mutadya

7,6 – 9,0 (136 – 162)

6,0 – 7,5 (110 – 135)

Gome 2. Zolinga zochizira mankhwalawa matenda a shuga a mtundu wachiwiri.