Tshuaj tua kab mob insulin yog dab tsi? Cov no yog cov autoantibodies uas tib neeg lub cev tsim tawm tsam nws cov insulin. AT rau insulin yog qhov cim tshwj xeeb tshaj plaws rau hom ntshav qab zib hom 1 (ntshav qab zib hom ntshav qab zib hom 1), thiab cov kev tshawb fawb tau raug xaiv los ua kev kuaj mob txawv txav ntawm tus kheej.
Yam 1 ntshav qab zib insulin-mob ntshav qab zib feem ntau tshwm sim los ntawm autoimmune kev puas tsuaj rau islets ntawm Langerhans caj pas. Cov kab mob no yuav ua rau muaj qhov tsis txaus ntawm cov tshuaj insulin hauv tib neeg lub cev.
Qhov no yog ib yam dab tsi ntawm cov ntshav qab zib hom 1 tau tawm tsam rau tus mob ntshav qab zib hom 2, uas tsis txuas nrog ntau yam tseem ceeb rau kev tiv thaiv kab mob. Kev kuaj mob ntshav sib txawv ntawm cov ntshav qab zib yog qhov tseem ceeb hauv kev kwv yees thiab cov tswv yim ntawm kev kho kom zoo.
Yuav ua li cas los txiav txim siab hom ntshav qab zib
Rau qhov txiav txim siab txawv ntawm cov mob ntshav qab zib mellitus, autoantibodies uas tau hais qhia tawm tsam islet beta hlwb raug kuaj.
Lub cev ntawm feem ntau ntawm cov ntshav qab zib hom 1 tsim cov tshuaj tiv thaiv rau cov ua haujlwm ntawm lawv tus kheej txoj kev ua tiav. Rau cov neeg muaj ntshav qab zib hom 2, mob hlwb zoo sib xws yog uncharacteristic.
Hauv hom 1 mob ntshav qab zib, cov tshuaj insulin ua haujlwm ua autoantigen. Cov tshuaj insulin yog qhov tshwj xeeb ntawm tus kws kho mob pib tua tus kheej.
Qhov cov tshuaj no txawv ntawm lwm cov autoantigens uas pom muaj hauv tus kab mob no (txhua yam protein ntawm islets ntawm Langerhans thiab glutamate decarboxylase).
Yog li, qhov cim tshwj xeeb tshaj plaws ntawm autoimmune pathology ntawm tus txiav ntshav ntawm ntshav qab zib hom 1 yog suav tias yog qhov kev kuaj mob zoo rau tshuaj tiv thaiv rau cov tshuaj insulin.
Autoantibodies rau insulin pom nyob rau hauv cov ntshav ntawm ib nrab ntawm cov neeg mob ntshav qab zib.
Ntawm hom ntshav qab zib hom 1, lwm cov tshuaj tiv thaiv kuj tseem muaj nyob hauv cov ntshav uas raug xa mus rau cov qe ntshav ntawm txoj hlab hlwb, piv txwv li, cov tshuaj tiv thaiv rau glutamate decarboxylase thiab lwm yam.
Nyob rau lub sijhawm thaum kuaj mob tau ua:
- 70% ntawm cov neeg mob muaj peb lossis ntau hom tshuaj tiv thaiv.
- Muaj ib hom pom nyob hauv tsawg dua 10%.
- Tsis muaj cov tshuaj autoantibodies tshwj xeeb hauv 2-4% ntawm cov neeg mob.
Txawm li cas los xij, cov tshuaj tiv thaiv rau cov tshuaj hormones rau ntshav qab zib tsis yog qhov ua rau kev loj hlob ntawm tus kab mob. Lawv tsuas yog xav txog kev puas tsuaj ntawm kev ua haujlwm ntawm pancreatic cell qauv. Tshuaj tua kab mob rau cov tshuaj insulin rau cov menyuam muaj ntshav qab zib hom 1 tuaj yeem pom ntau dua li cov laus.
Ua tib zoo mloog! Feem ntau, rau cov menyuam yaus uas muaj ntshav qab zib hom 1, cov tshuaj tiv thaiv rau cov insulin tshwm sim thawj zaug thiab cov kev xav ntau heev. Qhov zoo sib xws tau tshaj tawm hauv cov menyuam yaus hnub nyoog qis dua 3 xyoos.
Ua raws li cov cwj pwm no mus rau hauv tus lej, qhov kev xeem AT yog hnub no suav hais tias yog qhov kev kuaj mob soj ntsuam zoo tshaj plaws los tsim kev kuaj mob ntshav qab zib hom 1 hauv cov menyuam yaus.
Yuav kom tau txais cov ntaub ntawv tiav ntau tshaj plaws hauv kev kuaj mob ntshav qab zib, tsis yog tsuas yog kev tshuaj xyuas rau cov tshuaj tiv thaiv kab mob, tab sis kuj tseem muaj lwm tus yam ntxwv ntawm cov ntshav qab zib.
Yog tias tus menyuam yaus tsis muaj hyperglycemia muaj qhov cim ntawm qhov txhab autoimmune ntawm Langerhans islet cells, qhov no tsis txhais tau tias mob ntshav qab zib muaj nyob hauv hom 1 cov menyuam yaus. Thaum cov ntshav qab zib nce zuj zus, cov qib ntawm cov kab mob autoantibodies tsawg zuj zus thiab tuaj yeem ua tsis tiav.
Txoj kev pheej hmoo ntawm kis tus mob ntshav qab zib hom 1 los ntawm ncaus
Txawm hais tias qhov tseeb tshuaj tiv thaiv rau cov tshuaj hormones raug lees paub tias yog qhov cim tshaj plaws ntawm tus kabmob ntshav qab zib hom 1, nws muaj qee kis thaum cov tshuaj tiv thaiv kab mob ntshav tau tshawb pom nyob hauv hom 2 ntshav qab zib.
Tseem Ceeb! Ntshav qab zib hom 1 feem ntau yog pub muaj. Cov neeg feem ntau mob ntshav qab zib yog cov uas muaj hom HLA-DR4 thiab HLA-DR3 tib yam. Yog tias tus neeg muaj cov txheeb ze muaj tus mob ntshav qab zib hom 1, qhov pheej hmoo ntawm nws yuav mob hnyav nce ntxiv 15 zaug. Qhov feem pheej hmoo yuav raug yog 1:20.
Feem ntau, kab mob kev tiv thaiv kab mob ua rau lub cim ua cim ntawm lub hlwb ua rau lub hlwb ntawm islets ntawm Langerhans raug kuaj pom ntev ua ntej muaj ntshav qab zib hom 1. Qhov no yog vim qhov tseeb hais tias tag nrho cov qauv ntawm cov tsos mob ntawm tus mob ntshav qab zib xav tau kev puas tsuaj ntawm tus qauv ntawm 80-90% ntawm beta hlwb.
Yog li, kev kuaj kab mob autoantibody tuaj yeem siv los txheeb xyuas qhov kev pheej hmoo ntawm kev txhim kho ntshav qab zib hom 1 yav tom ntej rau cov neeg uas muaj keeb kwm muaj keeb kwm kab mob ntawm cov kab mob. Qhov pom muaj qhov cim ntshav ntawm qhov txhab txhab ntawm Largenhans islet cell hauv cov neeg mob no qhia txog 20% nce ntawm kev muaj mob ntshav qab zib hauv 10 xyoo tom ntej ntawm lawv lub neej.
Yog tias 2 lossis ntau dua cov tshuaj tiv thaiv insulin cov yam ntxwv ntawm cov ntshav qab zib hom 1 tau pom hauv cov ntshav, qhov ntau ntawm qhov tshwm sim ntawm tus kabmob 10 xyoo tom ntej hauv cov neeg mob no nce txog 90%.
Txawm hais tias qhov kev tshawb fawb ntawm cov tshuaj tiv thaiv kab mob qog nqaij hlav tsis tau pom zoo ua kev soj ntsuam rau cov ntshav qab zib hom 1 (qhov no tseem siv rau lwm qhov kev sim ntsuas), qhov kev tshuaj xyuas no tuaj yeem muaj txiaj ntsig zoo rau kev kuaj mob cov menyuam muaj lub nra ntsig txog hom ntshav qab zib hom 1.
Ua ke nrog kev kuaj ntshav qabzib, nws yuav tso cai rau koj kuaj ntshav ntshav qab zib hom 1 ua ntej tshaj tawm cov cim mob, nrog rau ketoacidosis uas mob ntshav qab zib. Cov cai ntawm C-peptide thaum lub sijhawm kuaj mob tseem ua txhaum. Cov ntaub ntawv no qhia tau cov nuj nqi zoo ntawm cov seem beta-cell muaj nuj nqi.
Nws tsim nyog pom tias qhov kev pheej hmoo ntawm kev tsim kab mob hauv tus neeg uas muaj kev kuaj mob rau cov tshuaj tiv thaiv insulin thiab qhov tsis muaj tsev neeg keeb kwm tsis zoo ntawm cov ntshav qab zib hom 1 tsis txawv ntawm kev pheej hmoo ntawm tus kab mob no hauv cov pej xeem.
Lub cev ntawm feem ntau ntawm cov neeg mob tau txais cov tshuaj insulin (rov ua kom zoo, exogenous insulin), tom qab ib pliag pib tsim cov tshuaj tiv thaiv rau cov tshuaj hormones.
Cov txiaj ntsig ntawm kev tshawb fawb hauv cov neeg mob no yuav zoo. Ntxiv mus, lawv tsis yog nyob ntawm seb qhov kev txhim kho ntawm cov tshuaj tiv thaiv rau cov tshuaj insulin yog endogenous lossis tsis.
Vim li no, kev tsom xam tsis haum rau kev kuaj mob ntshav qog ntshav qab zib hom 1 hauv cov neeg uas twb tau siv cov tshuaj insulin. Ib qho xwm txheej zoo sib xws tshwm sim thaum cov ntshav qab zib xav tias nyob hauv tus neeg tau kuaj mob ntshav qab zib hom 2 los ntawm kev ua yuam kev, thiab nws tau raug kho nrog exogenous insulin los kho tus mob hyperglycemia.
Mob kab mob
Feem ntau ntawm cov neeg mob uas muaj ntshav qab zib hom 1 muaj ib lossis ntau dua cov kabmob autoimmune. Feem ntau cov feem ntau nws muaj peev xwm txheeb xyuas:
- autoimmune lub qog ua haujlwm tsis zoo (Cov kab mob Graves, Hashimoto's thyroiditis);
- Addison's disease (thawj qhov tsis txaus adrenal);
- celiac kab mob (celiac enteropathy) thiab pernicious anemia.
Yog li, yog tias qhov cim ntawm tus kab mob autoimmune pathology ntawm cov qe ntshav raug kuaj pom thiab hom ntshav qab zib hom 1 tau paub tseeb, yuav tsum tau kuaj ntxiv. Lawv yuav tsum muaj txhawm rau tshem tawm cov kab mob no.
Vim li cas thiaj li xav tau kev tshawb fawb
- Txhawm rau tshem tawm hom 1 thiab ntshav qab zib hom 2 hauv tus neeg mob.
- Txhawm rau twv txoj kev loj hlob ntawm tus kab mob hauv cov neeg mob uas muaj keeb kwm muaj keeb kwm caj ces, tshwj xeeb tshaj yog cov menyuam yaus.
Thaum Twg Los Tso Qhov Kev Ntsuam Xyuas
Kev tsom xam tau raug sau tseg thaum tus neeg mob qhia txog cov tsos mob ntawm tus mob hyperglycemia:
- Muaj zis ntau ntxiv.
- Tubneeb.
- Tsis yuag yuag poob.
- Muaj ntau yam qab los noj mov.
- Txo qhov tsis hnov mob ntawm qhov qis qis dua.
- Pom kev tsis pom kev.
- Trophic mob rau ntawm txhais ceg.
- Ntev zoo mob.
Raws li pov thawj los ntawm kev soj ntsuam
Nquag: 0 - 10 Chav Nyob / ml.
Qhov taw qhia zoo:
- ntshav qab zib hom 1;
- Tus mob Hirat (AT insulin syndrome);
- polyendocrine autoimmune syndrome;
- lub xub ntiag ntawm cov tshuaj tiv thaiv ua rau exogenous thiab recombinant insulin npaj.
Qhov tshwm sim tsis zoo:
- qauv;
- lub xub ntiag ntawm cov tsos mob ntawm hyperglycemia qhia qhov muaj feem ntau ntawm hom 2 mob ntshav qab zib.
