Cov yam ntxwv ntawm cov chav kawm ntawm lub pathology, nrog rau cov hau kev rau nws txoj kev nrhiav, kho thiab tiv thaiv kev ntsuas yuav tau tham ntxiv.
Lada ntshav qab zib yog dab tsi (mob latent, latent)?
Ntshav qab zib lada yog ntshav qab zib rau cov neeg laus, uas yog tus kab mob ntawm lub cev autoimmune.Nws cov tsos mob thiab pib chav kawm zoo li mob ntshav qab zib hom 2, tab sis nyob rau hauv etiology nws yog ze rau qhov ua ntej, thaum lub cev tsim cov tshuaj tiv thaiv rau cov qauv beta ntawm cov txiav thiab glutamate decarboxylase.
Lub autoimmune keeb kwm ntawm lada - ntshav qab zib txhais tau tias tsis ua haujlwm, ua rau muaj kev tawm tsam ntawm kev tiv thaiv kab mob nrog rau nws tus kheej lub cev, tshwj xeeb, nrog nws cov txiav.
Vim li ntawd, lub cev poob nws lub peev xwm ua haujlwm ib txwm ua thiab ua nws txoj haujlwm kom tiav.
Sib txawv los ntawm ntshav qab zib
Yog li, qhov ua rau lada-ntshav qab zib yog autoimmune ntshawv siab, yog li ntawd, los ntawm cov txheej txheem kev txhim kho, nws muaj qhov zoo sib xws nrog hom 1 qab zib pathology. Qee tus neeg endocrinologist feem ntau suav tias yog mob ntshav qab zib latent los ua thawj ntawm, thawj hom insulin, vim tias ib tus kab mob latent tau faib ua 1.5.
Txawm li cas los xij, raws li qhov chaw kuaj mob, hom 1 thiab 1.5 pom zoo sib txawv, piv txwv li, hauv kev sib piv ntawm hom 1, nrog lada-ntshav qab zib:
- Lub pathological mob proceeds maj mam, nrog rau lwm lub sijhawm ntawm siab thiab qis insulin xav tau. Cov tsos mob me. Thawj qhov tshwm sim pom tshwm sim tuaj yeem tshwm sim hauv nruab nrab hnub nyoog.
- Feem ntau tsis muaj cov yam ntxwv zoo li ntshav qab zib li nqhis dej, nce ntxiv diuresis, poob phaus, ketoacidosis, thiab lwm yam.
Qhov sib txawv ntawm cov mob ntshav qab zib latent thiab pathology 2 cov ntaub ntawv yog:
- tsis muaj cov rog;
- qhov xav tau cov tshuaj insulin uas tshwm sim tom qab ib lub sijhawm (txog 6 xyoo);
- Cov tshuaj tiv thaiv kev tiv thaiv tsis zoo-GAD, IAA, ICA muaj cov kab mob hauv cov ntshav, paub tseeb tias qhov xwm txheej autoimmune ntawm cov txheej txheem;
- qhov concentration ntawm C-peptides yog qis dua 0.6 nmol / l, uas qhia tias tsis muaj peev xwm ntawm cov tshuaj insulin;
- Kev kuaj mob qhia pom muaj nyob hauv ntshav ntawm cov cim ntawm cov tshuaj insulin-hom 1 ntshav qab zib mellitus (qhov muaj zog HLA alleles). Qhov kev tshawb xyuas no tsis yog nqa los ntawm txhua lub chaw soj nstuam, tab sis nws yog qhov tsim nyog thaum tshem tawm ntawm cov teeb meem tsis sib haum xeeb txhawm rau txhawm rau txhawm rau txhawm rau txiav txim qhov mob.
- cov mob yog me ntsis nyiaj los ntawm qab zib-txo cov ntsiav tshuaj.
Cov pab pawg muaj kev pheej hmoo
lada-ntshav qab zib tau kuaj pom muaj ntau zaus ntawm 2 txog 15% hauv cov neeg mob uas muaj 2 cov kab mob ntshav qab zib thiab rog dhau. Hauv cov neeg mob ntshav qab zib ntawm yam no nrog lub cev hnyav, cov kab mob autoimmune tau sau npe rau yuav luag 50% ntawm cov neeg mob.
Cov kws kho mob tau tsim 5 cov qauv rau kev soj ntsuam qhov pheej hmoo ntawm lada-mob:
- hnub nyoog ntawm kev kuaj pom tus mob ntshav qab zib pathology ntev txog li 50 xyoo;
- qhov mob pib lub sij hawm pib mob nrog cov tsos mob xws li diuresis ntau dua 2 litres ib hnub, nqhis dej tas li, txo cov suab dav dav;
- tsis muaj cov cim ntawm kev rog;
- muaj cov kab mob autoimmune xws li mob caj dab, Hashimoto thyroiditis, cardiomyopathy, vitiligo thiab hais txog;
- muaj cov txheeb ze nyob ze ntawm kev txiav txim siab txog kev noj qab haus huv.
Yog tias 1 ntawm 5 ntawm cov tsos mob no tau pom, tom qab ntawv muaj peev xwm kis tus mob ntshav qab zib latent yuav nyob hauv thaj av ntawm 1%. Thaum muaj 2 lossis ntau dua ntawm cov cim no, qhov yuav tshwm sim nce mus txog 90% thiab cov kws kho mob pom zoo kom kuaj mob.
Cov tsos mob
Cov kab mob uas tsis muaj qab hau yog tsis txawv los ntawm cov tsos mob tshwj xeeb. Feem ntau, nws tshaj tawm nws tus kheej nrog pom qhov cim ntawm tus mob ntshav qab zib thib ob.
Tab sis muab hais tias ntau yam lada tseem hais txog thawj qhov subtype, kev nthuav qhia xws li:
- tas li kev nkees;
- Kev Nyuaj Siab
- kev nyuaj siab lub sij hawm dhau mus;
- muaj kev tshaib plab.
Kuj siv qhov chaw:
- muaj teeb meem ntawm daim tawv nqaij - dryness thiab tev tawm, muaj cov rwj thiab pob,
- cov pos hniav los ntshav thiab xoob hniav;
- nce ntawm cov ntshav qab zib ntawm 5,6 txog 6.2 mmol / l;
- erectile kawg nyob hauv cov txiv neej thiab tsis muaj kev ntshaw ntawm kev sib deev hauv poj niam;
- txo qis hauv qhov tsis haum ntawm cov ntiv tes thiab qee qhov chaw ntawm daim tawv nqaij.
Cov tsos mob zoo li no tuaj yeem tshwm sim ntau dua 5 xyoos, tom qab uas mob ntshav qab zib mellitus yuav kho tsis tau.
Cov cim ntawm pathology kuaj pom ntawm lub sijhawm nce ntxiv ntawm kev tiv thaiv exacerbations. Kev kho kom zoo yuav tsis cia cov ntawv latent los ua yam nquag, nrog rau txo nws txoj kev loj hlob qeeb.
Kev kuaj mob
Txhawm rau kom meej meej rau kev kuaj mob ntawm kev xav tias cov ntshav qab zib latent, cov nram qab no ntawm kev kuaj mob siv;
- kuaj ntshav rau cov tshuaj tiv thaiv rau lub enzyme glutamate decarboxylase, uas cov kab mob panocas endocrine hloov kho. Qhov tshwm sim tsis zoo txhais tau tias qhov kev pheej hmoo tsawg kawg ntawm cov ntshav qab zib cov menyuam yaus;
- kev soj ntsuam ntawm qeb ntawm C-peptides ntawm lub txiav. Nrog cov mob ntshav qab zib latent, nws yog qhov tsawg dua li ib txwm.
Txhawm rau kom tseeb tseeb kev kuaj mob, thov:
- "prednisone" kev xeem, uas tso cai rau koj los txiav txim siab txog qabzib;
- kev soj ntsuam Staub-Traugott, thaum cov ntshav noj ntawm lub plab tas yog tshuaj xyuas rau ob peb teev uas siv kho nrog dextropur.
Kev kho mob ntshav qab zib latent
Kev kho rau mob ntshav qab zib mob ploj zuj zus txhais tau hais tias kev tswj hwm ntawm insulin.
Txhawm rau txhim kho qhov rhiab ntawm peripheral qauv thiab cov ntaub so ntswg rau nws, cov tshuaj muaj suab thaj hauv cov ntsiav tshuaj tuaj yeem siv.
Ntxiv rau, glitazones thiab biguanide derivatives yog kho.
Ib qho tseem ceeb ntxiv rau kev kho mob yooj yim yuav yog:
- ua raws cov cai kev noj haus, hais kom ua zaub mov noj qis;
- kev tawm dag zog lub cev thiab tsim nyog.
Kev Tiv Thaiv
Txo qhov kev pheej hmoo ntawm kev tsim mob ntshav qab zib latent, nws yog ib qho tseem ceeb kom txo qis qhov cuam tshuam ntawm cov xwm txheej predisposing rau pathology:
- los tswj lub cev nyhav;
- ib sij ntsuam xyuas koj cov piam thaj hauv ntshav. Qhov no muaj tseeb tshwj xeeb rau cov neeg uas muaj lub laj thawj xav tias kev txhim kho ntawm cov kab mob endocrine pathologies, vim lawv muaj xwm txheej hauv kev noj qab haus huv lossis kev muaj mob caj ces;
- noj xwm yeem thiab noj sib npaug, zam qhov ntau ntawm cov zaub mov muaj carb siab;
- coj lub cev ua lub neej nquag;
- tswj lub cev tiv thaiv ntawm qib kom zoo, tsis txhob hnov qab noj cov tshuaj vitamins kom ntxiv dag zog tiv thaiv kab mob.
Tus kab mob ntshav qab zib pheej tsis muaj teeb meem tsawg dua li cov kab mob sib xws ntawm hom 1 thiab 2. Tsuas yog kev saib xyuas tus kheej rau kev noj qab haus huv yuav pab txheeb xyuas nws kom ncav sijhawm thiab siv txhua yam kev ntsuas tsim nyog los ua lub neej ntev thiab muaj sia.
