Tsis hnov qab cov carbohydrate metabolism hauv menyuam yaus feem ntau ua rau pom qhov tseeb ntawm cov keeb kwm kev tsis sib haum cuam tshuam nrog kev ua txhaum ntawm cov qauv ntawm cov chromosomes. Yog tias cov txheeb ze nyob ze ntawm tus menyuam muaj ntshav qab zib, yog li tus menyuam yaus no muaj kev pheej hmoo thiab nws yuav tsum tau kuaj cov ntshav qabzib.
Thaum cov tsos mob uas yuav cuam tshuam nrog cov ntshav qab zib tshwm sim, hu rau tus neeg endocrinologist thaum muaj xwm txheej ceev tsuas yog ua kom muaj kev noj qab haus huv zoo, vim tias cov yam ntxwv ntawm ntshav qab zib hauv cov menyuam yaus tuaj yeem txhim kho tau sai thiab nyiam txhawm rau ketones hauv cov ntshav. Ketoacidosis tej zaum yuav pom thawj qhov kev mob ntshav qab zib thaum yau ua rau lub cev tsis xeev (coma).
Txhawm rau kev kuaj mob kom raug, kev saib xyuas ntshav qabzib yuav tsim nyog, yog li koj yuav tsum paub tsis tas cov kev qhia glycemia ntawm lub plab khoob, tabsis tseem muaj ntshav qab zib cov ntshav hauv menyuam yaus tom qab noj mov tas.
Ntshav qab zib hauv cov menyuam yaus
Cov ntshav qab zib cov ntshav hauv menyuam yaus yog nyob ntawm lub xeev kev noj qab haus huv thiab hnub nyoog, nrog cov kab mob ntawm cov kab mob endocrine, kev tiv thaiv tsis muaj zog, nrog rau kev pub mis tsis zoo, nws tuaj yeem hloov pauv tau.
Yog tias tsis muaj cov kua nplaum ntev, kev loj hlob thiab kev loj hlob ntawm tus menyuam lub cev tsis tuaj yeem, vim nws yog qhov tseem ceeb rau kev tsim adenosine triphosphoric acid, lub zog tseem ceeb. Glycogen ua hauj lwm pab tam rau cov piam thaj hauv lub cev. Nws tau muab tso rau hauv lub hlwb ntawm daim siab thiab cov leeg nqaij ua kom siv thaum lub sijhawm thaum carbohydrates los ntawm cov zaub mov tsis tau txais.
Glycogen kuj tseem tuaj yeem noj thaum lub cev ua si, muab cov leeg ua zog nrog lub zog ua haujlwm. Tag nrho cov txheej txheem no tshwm sim nyob rau hauv kev tswj hwm ntawm lub hlwb thiab endocrine plab hnyuv siab raum, uas tswj kev nqus ntawm insulin thiab contrainsular cov tshuaj hormones.
Lub luag haujlwm ntawm cov kua nplaum tsis yog tsuas yog ua kom muaj kev koom tes hauv cov khoom noj metabolism. Nws yog ib feem ntawm cov protein, suav nrog cov ua ntej ntawm DNA thiab RNA, thiab cov glucuronic acid, uas tsim nyog los ua kom tsis txhob muaj cov co toxins, tshuaj, thiab tshem tawm cov bilirubin ntau dhau. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum muab cov piam thaj rau hauv lub hlwb yog qhov xwm yeem thiab ib txwm muaj.
Nrog ib qho kev txo qis ntawm cov ntshav hauv lub ntsej muag, uas tau kuaj pom vim yog cov receptors hauv phab ntsa ntawm cov hlab ntshav, nws qib nce vim qhov kev ua haujlwm ntawm cov tshuaj hormones no:
- Adrenocorticotropic cov tshuaj los ntawm lub caj pas pituitary. Muab cov qog adrenal tso rau ntawm cov tshuaj catecholamines thiab cortisol.
- Catecholamines txhim kho kev puas tsuaj ntawm glycogen hauv daim siab, tsim tawm los ntawm qog adrenal. Cov no suav nrog adrenaline thiab norepinephrine.
- Cortisol hauv lub siab pib pib tsim los ntawm cov piam thaj los ntawm glycerol, amino acids thiab lwm yam khoom tsis-carbohydrate.
- Glucagon tsim nyob rau hauv lub txiav, nws tso tawm rau hauv cov ntshav ua rau kev puas tsuaj ntawm cov khw muag khoom glycogen hauv lub siab ua rau cov kua nplaum nyob nrog.
Noj ua rau lub zais tso tawm ntawm cov qe ntshav, uas yog thaj chaw ntawm insulin hluavtaws hauv cov txiav ua qab. Ua tsaug rau cov tshuaj insulin, cov piam thaj molecules kov yeej cell cell thiab muaj nyob hauv cov txheej txheem biochemical.
Cov tshuaj Insulin kuj tseem tsim kho cov kev tsim cov glycogen hauv hepatocytes thiab cov leeg nqaij, txhim kho kev tsim cov protein thiab lipids. Hauv lub cev noj qab haus huv, cov txheej txheem no ua rau txo qis ntawm glycemia rau qhov ntsuas ntawm qhov muaj hnub nyoog.
Qhov txiaj ntsig ntawm cov piam thaj hauv cov ntshav ntawm tus menyuam
Kev kuaj ntshav qab zib hauv menyuam yaus tuaj yeem nqa hauv chaw kuaj mob lossis chaw kuaj ntshav ntiag tug, tab sis koj yuav tsum xav txog tias thaum siv ntau txoj hauv kev los txiav txim qhov kev cai, lawv tuaj yeem sib txawv, yog li koj yuav tsum xaiv ib lub chaw kuaj rau kev saib xyuas.
Qhov xwm txheej ntawm tus menyuam, lub sijhawm dhau los txij thaum pub mis kawg, kuj tseem ceeb, vim tias glycemia cov cim yuav hloov ib hnub. Yog li, ua ntej kev soj ntsuam, koj yuav tsum yauv kev kawm.
Kev tsom xam ua rau ntawm lub plab khoob. Tom qab kawg pub mis, uas yuav tsum tau 10 teev ua ntej kev kuaj, tus menyuam tuaj yeem tsuas haus nrog dej haus ib txwm haus. Yog tias koj kuaj tus menyuam yug lossis tus menyuam ua ntej rau lub hlis, tom qab ntawd ua ntej soj ntsuam, koj tuaj yeem pub rau tus menyuam tau 3 teev.
Cov menyuam yaus tsis pom zoo kom txhuam lawv cov hniav, vim tias cov menyuam yaus lub sijhawm yav dhau los yog qab zib thiab qab zib tuaj yeem nqus los ntawm lawv. Rau cov menyuam yug tshiab, cov ntshav qab zib cov qauv yog txij li 1.7 txog 4.2 mmol / L, rau cov menyuam mos - 2.5 - 4.65 mmol / L.
Rau cov menyuam yaus ntawm ib xyoos mus txog 14 xyoo, txoj kev tshawb no yog txiav txim siab nyob rau hauv qhov ib txwm muaj (hauv mmol / l) nrog rau cov ntsuas hauv qab no:
- Los ntawm 1 xyoos txog 6 xyoo: 3.3-5.1.
- Los ntawm 6 xyoo txog 12 xyoo: 3.3-5.6.
- Los ntawm 12 xyoo thiab laus dua 3.3 -5.5.
Kev soj ntsuam ntawm cov menyuam yaus thaum tsis muaj kev tsis txaus siab uas yuav muaj ntshav qab zib yuav ua tiav ib xyoos ib zaug, thiab yog tias tus menyuam muaj lub nra hnyav rau lub noob, tom qab ntawd txhua 3-4 lub hlis. Cov menyuam yaus no tau sau npe nrog kws kho mob menyuam yaus thiab tej zaum yuav raug txiav txim siab los ntawm qhov kev kawm tob txog cov metabolism hauv kev noj haus.
Yog tias cov cim ntsuas tau pom nyob rau hauv kev soj ntsuam rau cov piam thaj, ces tus kws kho mob feem ntau pom zoo kom noj nws dua, vim tias nws tuaj yeem cuam tshuam los ntawm kev nqus ntawm cov kua dej ntau, kev ntxhov siab pw tsaug zog, mob concomitant, thiab tseem cuam tshuam kev pw tsaug zog thiab zaub mov noj haus.
Kev yoo mov thiab cov ntshav qab zib cov ntshav tom qab noj mov kuj tuaj yeem sib txawv.
Ntxiv rau cov ntshav qab zib hauv cov menyuam yaus
Yog tias tus menyuam tsis suav rau tag nrho cov laj thawj ntawm kev tshuaj xyuas tsis raug (kev nyuaj siab lossis lub cev, kis mob), tom qab ntawd yuav tsum tau tshuaj xyuas ntshav qab zib ntxiv. Ntxiv rau cov ntshav qab zib nws tus kheej, ib qho kev nce qib ntawm cov piam thaj hauv cov menyuam yaus tshwm sim hauv cov kab mob ntawm lub caj pas pituitary, kev ua haujlwm tsis zoo ntawm hypothalamus, thiab kev yug me nyuam hauv lub caj pas tsis zoo.
Tsis tas li, hyperglycemia hauv ib tus menyuam yaus tuaj yeem tshwm sim nrog cov kab mob ntawm cov ua cov thyroid caj pas, mob qog ua rau lub siab, tsawg dua nrog kab mob pancreatitis. Tsis kuaj pom nyob rau lub sijhawm, kev qaug dab peg tuaj yeem tshwm sim nws tus kheej nrog muaj cov piam thaj ntxiv. Ib qho ntxiv, kev noj cov tshuaj hormones corticosteroid los kho cov kab mob sib kis ua rau cov ntshav qab zib muaj menyuam yaus.
Qhov teeb meem feem ntau tshaj plaws ntawm cov khoom noj hauv lub cev hauv cov tub ntxhais hluas yog cov rog, tshwj xeeb tshaj yog tias cov rog tsis tau tso tusyees, tab sis hauv plab. Hauv qhov no, cov ntaub so ntswg adipose muaj qhov tshwj xeeb ntawm kev tso cov tshuaj hauv cov ntshav uas txo cov lus teb ntawm cov cell rau insulin. Thiab txawm hais tias muaj ntau npaum li ntawm cov insulin hauv cov ntshav, tab sis nws cov nyhuv tsis tuaj yeem tshwm nws tus kheej.
Yog tias cov piam thaj hauv ntshav nce ntxiv ntau dua 6.1 mmol / l thiab tus menyuam muaj cov cim zoo li ntawm ntshav qab zib mellitus, nws tau qhia kev kho mob los ntawm endocrinologist. Cov tsos mob uas yuav ua rau muaj kev txhawj xeeb:
- Tus siab xav haus.
- Nce thiab nquag tso zis, pabcuam txaj.
- Tus menyuam pheej niaj hnub thov zaub mov.
- Muaj ntau zuj zus rau cov khoom qab zib.
- Tsis nce phaus ntxiv nrog rau qab los noj mov.
- Ob teev tom qab noj mov tas, tus me nyuam ua tsis taus pa, xav pw.
- Cov menyuam yaus rov qab los ua lub siab me lossis tsis muaj zog.
Ntshav qab zib mellitus tsis tshua muaj tshwm sim yam tsis muaj mob muaj keeb lossis kev rog, tab sis qhov teeb meem yog tias nws tsis tuaj yeem kuaj pom tas li, yog li ntawd, yog tias muaj kev xoom xaim ntawm ntshav qab zib, tus menyuam yuav tsum tau kuaj. Hauv cov xwm txheej zoo li no, ib qho kev kuaj ntshav qabzib tau raug tshuaj, lossis nws tseem hu ua "nkhaus suab thaj".
Txhua qhov kev tshwm sim ntawm cov ntshav qab zib, txawm tias kuaj ntshav ib txwm, thiab tseem yog tias tus menyuam thaum yug los muaj lub cev hnyav dua 4.5 kg, nws muaj cov txheeb ze muaj ntshav qab zib, lossis muaj cov kis mob nquag, kab mob ntawm daim tawv nqaij, pom kev tsis zoo uas tsis haum rau cov duab hauv tsev kho mob ib txwm muaj, qhia tau rau cov kuaj load.
Qhov kev sim no qhia tau hais tias cov ntshav qabzib hauv lub siab yuav nce siab npaum li cas tom qab noj mov, tau tawm sai li cas cov tshuaj insulin nrog kev siv cov piam thaj tau txais, puas muaj kev pheej hmoo ntawm kev muaj ntshav qab zib hauv menyuam yaus.
Ua ntej kev xeem, koj tsis tas yuav npaj tshwj xeeb, tus menyuam yuav tsum ua raws li kev noj zaub mov zoo thiab soj ntsuam 10 teev tom qab noj hmo thaum sawv ntxov. Txog hnub ntsuas, koj tuaj yeem haus qee cov dej dawb. Tus menyuam raug soj ntsuam txog kev yoo qab zib thiab tom qab noj qabzib tom qab 30 feeb, ib teev thiab ob teev.
Cov koob tshuaj ntshav yuav tsum muab xam raws qhov hnyav ntawm lub cev ntawm tus menyuam - 1.75 g ib 1 kg. Kua nplaum hmoov yog diluted hauv dej thiab tus menyuam yuav tsum haus nws. Nws suav hais tias ib txwm muaj rau cov menyuam yaus yog tias pom cov piam thaj hauv qab qis dua 7 mmol / l tom qab ob teev, thiab yog tias nws nce txog 11,1 mmol / l, tom qab ntawd tus menyuam muaj lub siab tsis kam lees rau cov khoom noj uas muaj cov khoom noj khoom haus carbohydrates, uas tuaj yeem tsim kho mob ntshav qab zib.
Yog tias muaj cov lej ntau dua tau sau tseg, tom qab ntawd qhov no yog qhov pom tseeb tias yog mob ntshav qab zib. Cov yam ntxwv mob ntshav qab zib hauv cov menyuam yaus yog:
- Cia li pib.
- Acute chav kawm.
- Zoo rau ketoacidosis.
- Feem ntau hom 1 ntshav qab zib mellitus uas xav tau kev kho mob insulin.
Mob ntshav qab zib (mob latent) mob ntshav qab zib mellitus feem ntau tshwm sim nrog tus kab mob 2 thiab nrog rau cov neeg rog, nrog rau kis kab mob siab lossis mob ntshav siab.
Cov menyuam yaus zoo li no tau qhia txog kev txwv ntawm carbohydrates nyob rau hauv lawv cov zaub mov noj thiab qhov yuav tsum tau txo lub cev qhov hnyav mus rau qhov qub.
Txo cov ntshav qab zib hauv tus menyuam
Txo cov piam thaj hauv qab cov cai hauv cov menyuam yaus tuaj yeem tshwm sim thaum kev tshaib plab, tshwj xeeb tshaj yog thaum tsis tuaj yeem haus dej tsis txaus, nrog cov kab mob ntawm lub plab zom mov, thaum, txawm hais tias noj mov, tus me nyuam zom nws cov kev zom zaub mov los ntawm pancreatic enzymes. Qhov no tuaj yeem nrog mob pancreatitis nyob rau theem mob lossis mob ntev.
Cov khiav ntawm cov piam thaj hauv cov hnyuv txuas nrog gastroenteritis, colitis, malabsorption syndromes, kab mob plab hnyuv, nrog rau lom. Qhov ua rau hypoglycemia nyob rau hauv cov ntshav qab zib mellitus hauv menyuam yaus yog cov kab mob endocrine nrog cov kev hloov hauv nruab nrog qis thiab txo qis cov tshuaj hormones los ntawm cov qog adrenal, cov thyroid caj pas.
Kuj, hypoglycemia tawm tsam pom muaj kev rog. Qhov no yog vim muaj cov kua dej hauv cov ntshav ntau dhau - thaum noj zaub mov nrog cov carbohydrates yooj yim, qhov kev txhawb ntxiv ntawm nws cov kev tshem tawm yog tshwm sim thiab cov piam thaj hauv cov ntshav qis dua theem ib txwm muaj.
Kuj muaj tsawg dua ntawm cov mob ntshav qab zib tsawg tshwm sim thaum:
- Insulinoma yog lub qog uas ua rau cov tshuaj insulin ntau dhau.
- Raug mob rau lub hlwb lossis kev loj hlob txawv txav.
- Lom nrog arsenic, chloroform, tshuaj, ntsev ntawm cov hlau nyhav.
- Cov kab mob ntshav: leukemia, lymphoma, hemoblastosis.
Feem ntau, nyob rau hauv kev kho mob ntshav qab zib hauv cov menyuam yaus nrog xaiv cov koob tshuaj insulin, kev tawm dag zog, kev noj zaub mov tsis zoo, cov menyuam yaus tuaj yeem ntsib kev mob ntshav qab zib. Lawv tuaj yeem tsim kho nrog kev noj qab haus huv zoo tag nrho. Kev ntxhov siab, arousal, thiab tawm hws tam sim ntawd tshwm sim. Nws yuav muaj txiaj ntsig los nyeem peb cov ntawv hais txog kev tiv thaiv ntshav qab zib hauv menyuam yaus.
Yog tias tus menyuam yaus tuaj yeem sib tham, feem ntau nws thov khoom qab zib lossis zaub mov. Tom qab ntawd kiv taub hau, mob taub hau, tshee tshee ntawm tes tshwm, nco qab yog ntxhov, thiab tus me nyuam tuaj yeem poob, qhov kev huam yuaj. Hauv cov xwm txheej zoo li no, koj yuav tsum nrawm ntsuas cov piam thaj, piam thaj lossis kua txiv qab zib. Cov yeeb yaj kiab hauv tsab xov xwm no yuav txuas ntxiv cov ncauj lus txog kuaj ntshav qab zib.
