Glycated hemoglobin yog qhov qhia tau cov ntshav biochemical uas qhia tau tias cov concentration ntawm cov piam thaj ntev ntev ntev. Glycohemoglobin muaj cov piam thaj thiab hemoglobin. Nws yog qib ntawm glycogemoglobin uas qhia txog hemoglobin ntau npaum li cas hauv cov ntshav txuas nrog cov roj molecules.
Txoj kev tshawb no yuav tsum tau nqa tawm hauv kev txhawm rau kuaj mob sai li sai tau muaj kab mob xws li mob ntshav qab zib, tiv thaiv kev txhim kho ntawm txhua yam kev cuam tshuam ntawm kev paub tseeb tias tus mob hyperglycemia. Rau kev tsom xam, cov khoom siv tshwj xeeb ntsuas yog siv.
Ib qho ntxiv, ntshav rau glycated hemoglobin yuav tsum tau pub rau los saib xyuas kev ua haujlwm ntawm kev kho ntshav qab zib. Qhov ntsuas no tau txiav txim siab raws li feem pua ntawm tag nrho hemoglobin.
Nws yog qhov tseem ceeb rau cov neeg mob ntshav qab zib mellitus, tsis hais tus qauv ntawm tus kab mob, kom nkag siab txog dab tsi glycated hemoglobin yog dab tsi thiab dab tsi yog nws txoj hauv kev mob ntshav qab zib mellitus. Koj yuav tsum paub tias qhov ntsuas no tau tsim vim qhov sib xyaw ntawm cov amino acids thiab qab zib. Tus nqi ntawm kev tsim thiab tus lej ntawm cov qe ntshav liab yog cuam tshuam nrog cov ntsuas ntawm glycemia. Raws li qhov tshwm sim, xws li hemoglobin tuaj yeem muaj ntau hom:
- HbA1c;
- HbA1a;
- HbA1b.
Vim li cas tias cov piam thaj hauv ntshav qab zib nce ntxiv, tshuaj lom neeg cov tshuaj tiv thaiv ntawm kev fusion ntawm hemoglobin nrog qab zib dhau mus sai, glycosylated hemoglobin nce. Lub neej cia siab ntawm cov ntshav liab nyob hauv hemoglobin yuav nruab nrab 120 hnub, yog li, kev txheeb xyuas yuav qhia tau ntev npaum li cas glycated hemoglobin index tau hloov pauv ntawm qhov tsis suav.
Qhov yog tias cov ntshav liab tau tuaj yeem khaws cia rau hauv lawv cov ntaub ntawv nco txog cov naj npawb ntawm hemoglobin lwg me me uas, dhau 3 lub hlis dhau los, tau txuas nrog cov suab roj molecules. Txawm li cas los xij, tib lub sijhawm, cov qe ntshav liab tuaj yeem muaj hnub nyoog sib txawv, yog li nws tsim nyog los ua qhov kev kawm txhua 2-3 lub hlis.
Kev tswj ntshav qab zib
Txhua tus neeg muaj glycated hemoglobin hauv cov ntshav, tab sis nws cov ntshav qab zib nce tsawg kawg 3 zaug, tshwj xeeb tshaj yog rau cov neeg mob tom qab 49 xyoo. Yog tias kho tau zoo txaus, tom qab 6 lub lis piam tus neeg muaj glycated hemoglobin zoo ntshav qab zib mellitus.
Yog tias koj piv hemoglobin rau cov ntshav qab zib thiab glycated hemoglobin rau cov ntsiab lus qab zib, kev tshuaj xyuas zaum ob yuav raug tseeb li sai tau. Nws yuav muab tswv yim ntawm lub xeev ntawm cov kab mob ntshav qab zib nyob rau hauv lub hlis tsis ntev los no.
Thaum tom qab kuaj ntshav thawj zaug nws pom tias cov ntshav glycated hemoglobin tseem nce siab, muaj kev qhia kom paub kho kom haum rau hauv kev kho mob ntshav qab zib. Qhov kev tsom xam no tseem yog qhov tseem ceeb los txiav txim siab qhov ua rau ntawm qhov kev ua tsis txaus siab ntawm cov kab mob pathological.
Raws li endocrinologist, nrog rau kev txo cov ntshav glycated hemoglobin, kev pheej hmoo ntawm ntshav qab zib thiab qog ntshav yuav tsawg dua li ib nrab. Yog vim li cas nws yog qhov tsim nyog:
- npaum li sai tau soj ntsuam rau qab zib;
- coj mus xeem.
Hmoov tsis zoo, koj tuaj yeem pub ntshav rau cov kev kawm no tsuas yog hauv cov chaw kuaj ntshav ntiag tug thiab chaw kho mob. Txog lub sijhawm, cov tsev kho mob hauv lub xeev tsis tshua muaj khoom tshwj xeeb.
Cov lus qhia rau txoj kev tshawb fawb yog nyob rau qee tus poj niam thaum lub cev xeeb tub, qhov no yog qhov tsim nyog rau kev kuaj mob ntawm kev sib kis mob ntshav qab zib mellitus.
Qee zaum ntsuas ntsuas tsis txaus ntseeg, qhov laj thawj rau qhov no yog qhov nce ntxiv ntawm cov poj niam cev xeeb tub, nrog rau lub sijhawm luv ntawm lub neej cov ntshav.
Qhov ntsuas ntsuas, txiaj ntsig npaum li cas
Txhawm rau txiav txim siab seb cov ntshav qab zib cov ntshav muaj ntshav siab li qub lossis tsis, 2 txoj kev tau siv tam sim ntawd - qhov no yog ntsuas lub plab tsis qab zib thiab ntsuas ntshav qab zib. Lub caij no, cov concentration ntawm cov piam thaj tuaj yeem sib txawv, nyob ntawm seb cov zaub mov noj thiab lwm yam. Yog li, cov ntshav qab zib tsis yog ib txwm tuaj yeem kuaj pom lub sijhawm.
Qhov kev xaiv zoo tshaj plaws yog los ua kev soj ntsuam ntawm glycosylated hemoglobin, nws yog cov ntaub ntawv thiab muaj tseeb, tsuas yog 1 ml ntawm cov ntshav txhaws ntawm cov ntshav tau noj los ntawm tus neeg mob. Nws tsis tuaj yeem pub ntshav tom qab tus neeg mob tau txais ntshav thiab tau txais kev phais mob, vim tias cov ntaub ntawv tau txais yuav tsis raug.
Yog tias tus mob ntshav qab zib muaj qhov cuab yeej tshwj xeeb rau kev tshawb fawb hauv tsev, nws tuaj yeem ua tau tom tsev xwb. Tsis ntev los no, cov cuab yeej no tau nce los ntawm kev coj cov kws kho mob thiab chaw kho mob. Lub cuab yeej yuav pab tsim cov feem pua ntawm hemoglobin hauv txhua tus neeg mob cov ntshav kuaj hauv ob peb feeb:
- venous;
- capillary.
Txhawm rau kom cov ntaub ntawv kev noj qab haus huv muaj tseeb, koj yuav tsum ua raws li cov lus qhia rau kev siv lub cuab yeej.
Txhawb glycosylated hemoglobin ntxiv rau mob ntshav qab zib qhia tias cov hlau tsis muaj peev xwm. Qeb ntawm hba1c, yog tias nws pib ntawm 5.5 thiab xaus ntawm 7%, qhia txog tus mob ntshav qab zib hom 1. Qhov ntau npaum li cas ntawm ib yam khoom los ntawm 6.5 rau 6.9 qhia txog qhov yuav tshwm sim ntawm hyperglycemia, txawm hais tias nyob rau hauv qhov teeb meem no nws yog ib qho tsim nyog yuav tsum pub ntshav ntxiv.
Yog tias tsis muaj txaus hemoglobin hauv kev txheeb xyuas, tus kws kho mob yuav kuaj pom cov ntshav qog ntshav qab zib, thiab qhov no kuj tseem yuav qhia tias muaj cov ntshav hemolytic tsis txaus.
Glycated hemoglobin
Hauv cov neeg muaj kev noj qab haus huv, tus nqi ntawm glycated hemoglobin yuav yog ntawm 4 txog 6.5% ntawm tag nrho hemoglobin. Hauv hom 2 mob ntshav qab zib mellitus, qhov kev tshuaj ntsuam yuav qhia pom tias muaj ntau yam hauv glycogemoglobin. Txhawm rau ua kom tus mob tshwm sim, ua ntej ntawm txhua qhov, nws tau pom tias yuav ua txhua yam ua tau los txo qis theem ntawm glycemia, tsuas yog nyob rau hauv cov xwm txheej no nws muaj peev xwm ua tiav kev hloov pauv kev kho mob ntshav qab zib, kom ua tiav qib siab ntawm glycated hemoglobin.
Nws yog pov thawj hais tias thaum lub siab ntawm glycated hemoglobin ntau dhau los ntawm tsawg kawg 1%, qab zib dhia tawm tam sim ntawd los ntawm 2 mmol / L. Nrog glycated hemoglobin nce ntxiv rau 8%, glycemia muaj nuj nqis ntau yam ntawm 8.2 txog 10.0 mmol / L. Hauv qhov no, muaj kev taw qhia los kho cov khoom noj khoom haus. Hemoglobin 6 yog qhov qub.
Thaum glycated hemoglobin cov cai rau ntshav qab zib tau nce li 14%, qhov no qhia tias 13-20 mmol / L ntawm cov piam thaj tam sim no nyob rau hauv cov ntshav. Yog li, nws yog ib qho tsim nyog kom nrhiav kev pab ntawm kws kho mob kom sai li sai tau, ib qho xwm txheej zoo sib xws tuaj yeem yog qhov tseem ceeb thiab ua rau muaj teeb meem.
Qhov qhia tau ncaj qha rau kev tsom xam yuav yog ib lossis ntau cov tsos mob:
- causeless qhov ceeb thawj poob;
- mloog tsis tseg txoj kev ua kom nkees nkees;
- tas li qhuav lub qhov ncauj, nqhis dej;
- nquag tso zis, tso zis ntau ntxiv.
Feem ntau cov feem ntau, kev tshwm sim thiab kev txhim kho ntawm ntau yam pathologies yog cuam tshuam nrog kev nce ntxiv hauv cov piam thaj. Cov neeg mob muaj ntshav siab thiab rog dhau ntawm qhov sib txawv heev yog qhov ua rau qhov no yooj yim tshaj plaws.
Cov neeg mob no tau yuam kom siv sij hawm ntxiv tshuaj kho mob kom rov ua rau lawv lub cev, rau cov mob ntshav qab zib nws yog qhov tseem ceeb heev. Muaj qhov muaj feem ntau ntawm cov teeb meem nrog ntshav qab zib nrog cov roj ntsha tsis zoo, uas yog ib qho kev xav ua rau cov kab mob metabolic thiab ntshav qab zib.
Hauv cov ntsiab lus no, nws yog ib qho tsim nyog yuav tsum ua kom cov piam thaj nyob hauv kev tswj tas li. Kev tshuaj xyuas hauv tsev yog qhia yog tias tsim nyog, kev soj ntsuam lub cev tag nrho, nrog paub tseeb tias teeb meem metabolic, nyob rau hauv muaj pathologies ntawm lub txiav.
Koj tuaj yeem tau txais cov txiaj ntsig tseeb ntawm kev ntsuam xyuas tau muab qee yam uas xav tau rau txoj kev tshawb fawb tau ntsib, uas yog:
- cov ntshav tau pub rau hauv lub plab khoob, cov zaub mov kawg yuav tsum tsis pub dhau 8 teev ua ntej kev soj ntsuam, haus cov dej huv tshwj tsis muaj roj;
- ob peb hnub ua ntej kuaj ntshav, lawv tso cawv thiab haus luam yeeb;
- Ua ntej kev txheeb xyuas, tsis txhob zom cov pos hniav, txhuam koj cov hniav.
Nws zoo heev yog tias koj tsum tsis siv txhua yam tshuaj ua ntej kuaj glycated hemoglobin rau ntshav qab zib. Txawm li cas los xij, koj tsis tuaj yeem ua qhov no ntawm koj tus kheej, koj yuav tsum tham nrog tus kws kho mob.
Qhov zoo thiab qhov tsis zoo ntawm kev txheeb xyuas
Kev kuaj ntshav rau glycated hemoglobin muaj ob qho tag nrho nws qhov pom tseeb thiab qhov tsis zoo. Yog li, kev tsom xam pab tsim kom muaj cov kabmob raws li qhov muaj tseeb thaum pib ntawm nws txoj kev loj hlob, nws yog nqa tawm hauv ob peb feeb, tsis npaj rau kev npaj hnyav.
Kev ntsuam xyuas yuav qhia tau meej tias muaj cov hyperglycemia, lub sijhawm ntawm cov kab mob pathological no, ntau npaum li cas ntawm tus neeg mob tswj cov qib suab thaj hauv cov ntshav. Ntxiv mus, qhov tshwm sim raug yog txawm nyob ntawm qhov muaj kev ntxhov siab, ntxhov siab thiab mob khaub thuas. Koj tuaj yeem pub ntshav thaum noj qee yam tshuaj.
Nws kuj tseem yuav tsum tau qhia txog qhov tsis zoo ntawm cov qauv, lawv suav nrog tus nqi siab ntawm txoj kev tshawb no, yog tias peb piv nws nrog kev txiav txim siab cov ntshav qab zib hauv lwm txoj kev. Qhov tshwm sim tuaj yeem yog qhov tsis muaj tseeb yog tias muaj kab mob hauv ntshav qab zib mellitus lossis hemoglobinopathy.
Kev tsom xam rau glycated hemoglobin tej zaum yuav tsis muaj tseeb yog tias tus neeg mob nyob rau Hmo ua ntej coj ntau dhau:
- ascorbic acid;
- Vitamin E.
Koj yuav tsum paub tias cov ntsuas pib nce ntxiv nrog cov ntshav qab zib ib txwm, qhov no tshwm sim nrog ntau dhau ntawm cov thyroid hormones txaus.
Endocrinologist hais tias nrog ntshav qab zib hom 1, ntshav tau pub rau glycated hemoglobin tsawg kawg 4 zaug, ntshav qab zib hom 2 xav tau kuaj 2 zaug. Qee tus neeg mob yuav pom cov ntsuas siab dhau, yog li lawv txhob txwm twv txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau soj. Tib lub sijhawm, xws li kev ntshai yuav tsis ua rau txhua yam zoo, tus kabmob yuav vam meej, cov ntshav qab zib yuav nce sai.
Nws yog ib qho tseem ceeb heev uas yauv mus kuaj ntshav thaum cev xeeb tub, nrog txo tus hemoglobin:
- muaj kev ncua sij hawm hauv kev txhim kho ntawm lub cev xeeb tub;
- qhov tsos mob no txawm yuav ua rau kev txiav cev tsis tab seeb.
Raws li koj paub, kev coj tus kheej yuav tsum tau nce kev noj cov khoom muaj hlau, txwv tsis pub cov teeb meem nrog glycated hemoglobin nyuaj tswj hwm.
Raws li rau cov mob hlwb, cov ntshav siab glycated hemoglobin kuj txaus ntshai rau lawv. Txawm li cas los xij, txawm hais tias qhov ntsuas no tau dhau 10%, nws yog txwv tsis pub txo kom nrawm heev, txwv tsis pub poob qis yuav txo qhov pom tseeb. Nws yog qhia rau normalize qib ntawm glycogemoglobin maj mam.
Daim vis dis aus hauv tsab xov xwm no yuav tham txog cov yam ntxwv ntawm kev tsom xam rau glycated hemoglobin.
