Cov lactate ntau dhau los qhov twg los?
Nyob hauv kev cuam tshuam ntawm biochemical catalysts, cov piam thaj molecule decomposes thiab tsim ob pyruvic acid lwg me me (pyruvate). Nrog cov pa oxygen txaus, pyruvate dhau los ua cov khoom siv rau feem ntau cov kev ua tiav metabolic hauv lub cell. Thaum muaj pa oxygen tshaib plab, nws hloov mus ua lactate. Qhov me me ntawm nws yog qhov tsim nyog rau lub cev, lactate xa rov qab rau daim siab thiab hloov pauv rov qab mus rau kua nplaum. Cov ntaub ntawv no cov xaiv yaam khoom ntawm glycogen.
Nquag, qhov piv ntawm pyruvate thiab lactate yog 10: 1, nyob hauv qab ntawm lwm yam sab nraud, qhov sib npaug tuaj yeem hloov mus. Muaj ib qho mob uas yuav txo tau txoj sia - lactic acidosis.
- cov ntaub so ntswg hypoxia (ua kom lub cev tsis haum, lom carbon dioxide lom, mob hnyav txaus, qaug dab peg);
- tsis muaj ntaub so ntswg oxygen starvation (lom nrog methanol, cyanides, biguanides, lub raum / nplooj siab tsis ua haujlwm, oncology, mob hnyav, mob ntshav qab zib mellitus).
Ib qho kev nce qib tseem ceeb ntawm cov qib lactic acid hauv lub cev yog qhov mob uas yuav tsum tau ua rau lub tsev kho mob sai. Txog li 50% ntawm cov neeg uas pom tau yog tuag!
Ua rau Cov Mob Ntshav Qab Zib Lactic Acidosis
Kev faib tawm ntau ntawm cov kev tawm tsam ntawm cov kab mob lactic acidosis tshwm sim hauv cov neeg uas tau noj tshuaj hypoglycemic. Niaj hnub nimno biguanides (metformin) tsis ua rau kom muaj kev sib txuam ntau ntxiv ntawm cov kab mob lactic acid hauv lub cev, txawm li cas los xij, yog tias muaj ntau qhov kev ua kom mob (kis tus kab mob, mob, mob lom, haus cawv, haus dej cawv ntau dhau ntawm lub cev) tshwm sim, lawv tuaj yeem pab ua kom muaj kab mob.
Cov tsos mob ntawm tus kab mob lactic acidosis hauv ntshav qab zib
Kev nkees nkees, tsis muaj zog, nkees nkees, nyob rau hauv cov ceg ntawm lub plab yog pom, xeev siab, ntuav feem ntau yuav ntuav. Lactic acidosis yog qhov txaus ntshai vim tias nws loj hlob sai sai hauv ob peb teev. Tom qab cov tsos mob uas nquag muaj ntshav qab zib, zawv plab, ntuav, thiab tsis meej pem tshwm sim sai heev. Tib lub sijhawm, tsis muaj lub cev ketone hauv cov zis, tsis muaj ntxhiab tsw ntawm acetone.Kev Kho Mob hyperlactatacidemia
- Yog tias ph qis dua 7.0, txoj hauv kev los cawm tus neeg mob tsuas yog mob hemodialysis - ntshav ntxuav.
- Txhawm rau tshem tawm cov pa roj carbon ntau dhau, yuav tsum ua kom lub ntsws tsis txhob tawg.
- Hauv cov teeb meem me, nrog lub sijhawm mus rau cov kws tshaj lij, cov dej ntws tawm nrog cov tshuaj alkaline (sodium bicarbonate, trisamine) tau txaus. Tus nqi tswj hwm yog nyob ntawm lub hauv siab txhaws. Thaum koj cov metabolism hauv kev ua kom zoo dua, koj tuaj yeem pib txo qis koj cov ntshav kev ntshav siab. Rau qhov no, ntau yam qauv rau kev tswj cov kua nplaum nrog insulin tuaj yeem siv. Raws li txoj cai, qhov no yog 2-8 units. nrog ceev ntawm 100-250 ml / h.
- Yog hais tias tus neeg mob muaj lwm yam cuam tshuam nrog cov kab mob lactic acidosis (lom, ntshav liab), lawv txoj kev kho yog nqa tawm raws li lub ntsiab cai classical.
Nws yuav luag tsis yooj yim sua los muab cov kev pabcuam ua ntej rau cov cim ntawm lactic acidosis. Txhawm rau txo cov kua qaub ntawm cov ntshav sab nraum lub tsev kho mob yuav tsis ua haujlwm. Alkaline ntxhia dej thiab dej qab zib cov kev daws teeb meem yuav tsis coj mus rau qhov txiaj ntsig yam xav tau. Nrog rau kev ntsuas ntshav qis los yog kev poob siab, kev siv tshuaj dopamine tsuas tsim nyog. Nws yog ib qho tsim nyog kom ntseeg tau tias cov cua ntws ntau tshaj plaws, thaum tsis muaj lub ncoo pa hauv ncoo lossis lub nqus pa, koj tuaj yeem qhib lub vaum vaum thiab qhib txhua lub qhov rais.Tus mob txhawm rau kom rov zoo los ntawm lactic acidosis yog neeg pluag. Txawm tias kev kho mob kom tsim nyog thiab nkag mus cuag sijhawm rau cov kws kho mob tsis tuaj yeem lav tias yuav cawm tau txoj sia. Yog li, cov neeg mob ntshav qab zib, tshwj xeeb tshaj yog cov uas siv cov tshuaj metformin, yuav tsum mloog zoo rau lawv lub cev thiab khaws lawv cov piam thaj hauv cov hom phiaj.
