Antibodies rau cov tshuaj insulin yog tsim tawm tsam lawv cov insulin sab hauv. Ntawm cov tshuaj insulin yog qhov raug ntaus cim tshwj xeeb tshaj plaws rau ntshav qab zib hom 1. Cov kev tshawb fawb yuav tsum tau muab coj los soj ntsuam tus kab mob.
Hom I mob ntshav qab zib mellitus tshwm vim yog autoimmune kev puas tsuaj rau cov islets ntawm Langerhans caj pas. Xws li lub pathology ua rau muaj kev ua tiav ntawm insulin hauv tib neeg lub cev.
Yog li, ntshav qab zib hom 1 tau tawm tsam rau hom 2 mob ntshav qab zib, tom kawg tsis txuas ntau qhov tseem ceeb rau kev tiv thaiv kab mob. Nrog kev pab los ntawm kev kuaj mob sib txawv ntawm cov mob ntshav qab zib, kev kuaj mob tuaj yeem nqa tawm kom zoo li ua tau thiab txoj cai kho kom zoo tuaj yeem raug xaiv.
Kev txiav txim ntawm cov tshuaj tiv thaiv rau cov insulin
Nws yog tus cim rau lub qhov txhab kab mob ntawm lub cev ua haujlwm ntawm tus kab mob pancreatic beta hlwb uas tsim cov tshuaj insulin.
Autoantibodies rau kev siv tshuaj insulin yog cov tshuaj tiv thaiv kab mob uas tuaj yeem raug kuaj hauv cov ntshav ntshav ntawm cov ntshav qab zib hom 1 ua ntej kho cov tshuaj insulin.
Kev qhia rau kev siv yog:
- kuaj mob ntshav qab zib
- kev kho cov tshuaj insulin,
- kuaj mob ntawm thawj theem pib ntawm ntshav qab zib,
- kuaj mob ntshav qab zib.
Cov tsos mob ntawm cov tshuaj tiv thaiv ua rau cuam tshuam nrog tus neeg lub hnub nyoog. Yuav kuaj pom cov tshuaj tiv thaiv no yuav luag txhua qhov mob yog tias mob ntshav qab zib tshwm rau cov menyuam yaus hnub nyoog qis dua tsib xyoos. Hauv 20% ntawm cov neeg mob, qhov tshuaj tiv thaiv yog pom hauv cov neeg muaj ntshav qab zib hom 1.
Yog tias tsis muaj hyperglycemia, tab sis muaj cov tshuaj tiv thaiv, ces kev txheeb xyuas tus mob ntshav qab zib hom 1 tsis tau lees paub. Thaum lub sijhawm ua haujlwm ntawm tus kabmob, qib ntawm cov tshuaj tiv thaiv rau cov insulin tsawg dua, nce mus txog lawv qhov kev ploj tag.
Cov neeg mob ntshav qab zib feem ntau muaj cov HLA-DR3 thiab HLA-DR4 noob. Yog tias cov txheeb ze muaj mob ntshav qab zib hom 1, qhov yuav tshwm sim muaj mob ntau dua 15 zaug. Cov tsos mob ntawm autoantibodies rau insulin yog sau ntev ua ntej thawj cov tsos mob ntawm tus mob ntshav qab zib.
Rau cov tsos mob, nce txog 85% ntawm cov hlwb hlwb yuav tsum tau muab pov tseg. Kev soj ntsuam ntawm cov tshuaj tiv thaiv no ntsuas qhov kev pheej hmoo ntawm cov ntshav qab zib yav tom ntej hauv cov neeg muaj mob predisposition.
Yog tias tus menyuam muaj lub caj ces roj ntsha muaj lub cev tiv thaiv kab mob rau cov tshuaj insulin, qhov kev pheej hmoo ntawm kev tsim cov ntshav qab zib hom 1 hauv kaum xyoo tom ntej no nce ntxiv li 20%.
Yog tias ob lossis ntau dua cov tshuaj tiv thaiv tau pom tias tshwj xeeb rau hom 1 mob ntshav qab zib mellitus, qhov yuav tshwm sim muaj mob nce mus rau 90%. Yog tias ib tus neeg tau txais cov tshuaj insulin (ua kom zoo, ua kom rov zoo ntxiv) hauv kev kho ntshav qab zib, tom qab ntawd lub sijhawm dhau los lub cev pib tsim cov tshuaj tiv thaiv rau nws.
Kev tsom xam hauv qhov no yuav yog qhov zoo. Txawm li cas los xij, kev tshuaj ntsuam tsis ua rau nws muaj peev xwm nkag siab tias puas yog cov tshuaj tiv thaiv rau cov tshuaj tiv thaiv sab hauv lossis sab nraud tsim tawm.
Raws li cov tshuaj insulin kho nyob rau hauv cov neeg mob ntshav qab zib, cov naj npawb ntawm cov tshuaj tiv thaiv rau cov insulin sab nraud hauv cov ntshav nce siab, uas tuaj yeem ua rau insulin tsis kam thiab cuam tshuam kev kho mob.
Nws yuav tsum tau yug hauv siab tias qhov tshuaj tiv thaiv insulin tuaj yeem tshwm sim thaum kev kho mob nrog kev ua kom tsis txaus ntxig kua txiv insulin npaj.
Txhais cov hom mob ntshav qab zib
Autoantibodies qhia rau islet beta hlwb raug kawm los txiav txim siab cov ntshav qab zib. Qhov muaj sia ntawm cov neeg feem coob uas muaj tus kab mob ntshav qab zib hom 1 ua cov tshuaj tiv thaiv lub cev ua rau lawv cov kab mob ua paug. Xws li cov tshuaj tiv thaiv kab mob tsis yog yam ntxwv ntawm tus mob ntshav qab zib hom 2.
Ntawm ntshav qab zib hom 1, insulin yog tus mob autoantigen. Rau cov txiav, cov tshuaj ntshav yog qhov tshwj xeeb tshaj tawm autoantigen. Qhov tshuaj hormones no txawv ntawm lwm cov autoantigens uas muaj nyob hauv tus kabmob no.
Autoantibodies rau cov tshuaj insulin yog kuaj pom hauv cov ntshav ntau dua 50% ntawm cov neeg muaj ntshav qab zib. Hauv hom kab mob 1, muaj lwm cov tshuaj tiv thaiv nyob rau hauv cov hlab ntshav uas muaj feem xyuam nrog cov qe hlwb ntawm cov txiav, piv txwv li, cov tshuaj tiv thaiv rau glutamate decarboxylase.
Thaum kuaj pom:
- kwv yees li 70% ntawm cov neeg mob muaj peb lossis ntau hom tshuaj tiv thaiv,
- tsawg dua 10% muaj ib hom,
- tsis muaj cov tshuaj autoantibodies tshwj xeeb hauv 2-4% ntawm cov neeg mob.
Nws yog tsim nyog sau cia tias cov tshuaj tiv thaiv rau cov tshuaj hormone insulin hauv kev mob ntshav qab zib mellitus tsis yog qhov tsim nyog ntawm tus kab mob. Cov tiv thaiv kab mob tsuas yog qhia kev puas tsuaj ntawm pancreatic hlwb. Cov tshuaj tiv thaiv kab mob rau insulin hauv cov menyuam muaj ntshav qab zib hom 1 tuaj yeem pom tshwm sim ntau dua li cov neeg loj.
Nws yog ib qho tseem ceeb kom them sai sai rau qhov tseeb tias, raws li txoj cai, hauv cov menyuam yaus uas muaj ntshav qab zib hom 1, xws li cov tshuaj tiv thaiv kab mob tshwm sim thawj zaug thiab hauv siab. Cov qauv no raug pom tshwj xeeb tshaj yog cov menyuam yaus hnub nyoog qis dua peb xyoos.
Nkag siab txog cov yam ntxwv no, xws li kev tshawb xyuas hnub no tau lees paub tias yog qhov kev sim zoo tshaj plaws rau kev kuaj mob ntshav qab zib mellitus thaum yau.
Yuav kom tau txais cov ntaub ntawv tiav ntau tshaj plaws ntawm kev kuaj mob ntshav qab zib, tsis yog tsuas yog kuaj cov tshuaj tiv thaiv kab mob xwb, tab sis kuj tseem tsom rau kev kuaj pom tus kab mob autoantibodies.
Yog tias tus me nyuam tsis muaj hyperglycemia, tab sis tus cim ntawm qhov txhab autoimmune ntawm cov hlwb ntawm islets ntawm Langerhans raug kuaj, qhov no tsis txhais tau tias muaj hom 1 ntshav qab zib mellitus.
Thaum cov ntshav qab zib nce zuj zus, cov qib ntawm cov kab mob autoantibodies tsawg zuj zus thiab tuaj yeem ua tsis tiav.
Thaum kawm ntawv tau teev tseg
Qhov kev tshuaj ntsuam xyuas yuav tsum tau txiav txim siab yog tias tus neeg mob tau kuaj mob cov tsos mob ntawm hyperglycemia, uas yog:
- nqhis dej heev
- nce ntxiv tso zis
- cia li poob ceeb thawj
- muaj zog qab los noj mov
- qis dua qhov paub ntawm qis qis dua,
- txo nyob rau hauv kev pom tseeb tseeb,
- mob rwj, mob txhab tes taw,
- qhov txhab uas tsis zoo mob ntev.
Txhawm rau soj ntsuam cov tshuaj tiv thaiv rau cov tshuaj insulin, koj yuav tsum sab laj rau qhov tshuaj tiv thaiv kab mob lossis sab laj rheumatologist.
Npaj ntshav kuaj
Ua ntej, tus kws kho mob piav qhia rau tus neeg mob xav tau qhov kev kawm no. Nws yuav tsum nco ntsoov txog tus qauv ntawm kev kho mob thiab kev coj tus yam ntxwv, vim tias txhua tus neeg muaj qee tus neeg.
Qhov kev xaiv zoo tshaj plaws yuav yog kev sim ntshav los ntawm kev sim tshuaj los yog kws kho mob. Nws yog ib qho tsim nyog yuav tsum tau piav qhia rau tus neeg mob tias qhov kev tshawb xyuas no tau ua los kuaj ntshav qab zib. Ntau tus yuav tsum piav qhia tias tus kabmob tsis tuag, thiab yog tias koj ua raws li txoj cai, koj tuaj yeem ua lub neej tag nrho.
Cov ntshav yuav tsum tau pub thaum sawv ntxov nyob rau ntawm lub plab khoob, koj tsis tuaj yeem txawm haus kas fes lossis tshuaj yej. Koj muaj peev xwm haus dej nkaus xwb. Koj tuaj yeem tsis tuaj yeem noj 8 teev ua ntej kev kuaj mob. Hnub ua ntej qhov kev ntsuam xyuas raug txwv:
- haus dej haus cawv
- noj zaub mov kib
- mus ua kis las.
Tso ntshav ntsuas rau kev tsom xam yog nqa tawm raws li hauv qab no:
- cov ntshav tau sau rau hauv qhov npaj ntsuas lub raj (nws tuaj yeem yog nrog kev sib cais gel lossis khoob),
- tom qab noj ntshav, thaj chaw hno yog clamped nrog lub paj rwb pas nrig,
Yog tias qhov ntshav liab tshwm sim hauv thaj tsam puncture, tus kws kho mob tau sau ntawv sov kom sov.
Qhov txheeb xyuas tau hais li cas?
Yog tias qhov kev tsom xam tau zoo, qhov no qhia tau tias:
- ntshav qab zib hom 1
- Hirat's kab mob
- polyendocrine autoimmune syndrome,
- muaj cov tshuaj tiv thaiv kom rov ua tau cov tshuaj insulin thiab exogenous.
Qhov kuaj pom tsis zoo yog suav tias yog ib txwm.
Mob ailments
Thaum kuaj pom lub cim ntawm kab mob autoimmune beta-cell pathologies thiab paub meej tias hom ntshav qab zib hom 1, kev tshawb fawb ntxiv yuav tsum tau kho. Lawv tsim nyog yuav tau tshem tawm cov mob no.
Hauv feem ntau hom 1 mob ntshav qab zib, ib lossis ntau dua autoimmune pathologies tau pom.
Feem ntau, cov no yog:
- autoimmune pathologies ntawm cov thyroid caj pas, piv txwv li, Hashimoto's thyroiditis thiab Graves kab mob,
- thawj adrenal tsis ua hauj lwm (Addison's disease),
- kab mob celiac, i.e. gluten enteropathy thiab pernicious anemia.
Nws tseem yog ib qho tseem ceeb rau kev tshawb fawb rau ob hom mob ntshav qab zib. Ib qho ntxiv, koj yuav tsum paub txog kev ntsuas ntawm tus kab mob hauv cov neeg uas muaj keeb kwm caj ces, tshwj xeeb tshaj yog cov menyuam yaus. Daim vis dis aus hauv tsab xov xwm no qhia txog lub cev paub txog cov tshuaj tiv thaiv kabmob ua haujlwm.
