Abanye abantu babiza uhlobo oluthembele nge-insulin yesifo sikashukela i-steroid. Imvamisa, iba ngenxa yobukhona egazini lenani elandayo lama-corticosteroids isikhathi eside. Lawa ngamahomoni akhiqizwa yi-adrenal cortex. Izimpawu nokwelashwa kwesifo sikashukela se-steroid kufanele kwaziwe kuwo wonke umuntu oye wahlangabezana nalolu hlobo lokugula.
Ukuthuthukiswa kwesifo sikashukela i-mellitus
Uhlobo lwesifo esincike kakhulu se-steroidal kwesinye isikhathi sibizwa ngokuthi i-mellitus yesibili noma i-mellitus yesifo sikashukela. Enye yezimbangela ezivamile zokuvela kwayo ukusetshenziswa kwemithi ye-hormonal.
Ngokusetshenziswa kwezidakamizwa ze-glucocorticosteroid, ukwakheka kwe-glycogen esibindini kuthuthukiswa kakhulu. Lokhu kuholela ekukhuleni kwe-glycemia. Ukuvela kwesifo sikashukela mellitus kungenzeka ngokusetshenziswa kwe-glucocorticosteroids:
- I-Dexamethasone;
- IHydrocortisone;
- I-Prednisone.
Lezi izidakamizwa ezilwa nokuvuvukala ezichazwe ekwelapheni i-asthma ye-bronchial, i-rheumatoid arthritis, kanye nezilonda eziningana ze-autoimmune (lupus erythematosus, eczema, pemphigus). Zingabekelwa nesifo se-sclerosis esiningi.
Lesi sifo singakhula futhi ngenxa yokusebenzisa ezinye izindlela zokuvimbela inzalo ngomlomo kanye ne-thiazide diuretics: INephrix, Hypothiazide, Dichlothiazide, Navidrex.
Ngemuva kokufakelwa kwezinso, ukwelashwa okuqhubeka isikhathi eside kwe-corticosteroid kuyadingeka. Ngemuva kwakho konke, ngemuva kokuhlinzwa okunjalo, kuyadingeka ukuthi uthathe imishanguzo ecindezela amasosha omzimba. Kodwa ukusetshenziswa kwe-corticosteroids akuhlali kuholele kushukela. Kalula, uma usebenzisa imali engenhla, amathuba okuthola lesi sifo ayanda.
Uma iziguli zangaphambili bezingenayo imishanguzo ye-carbohydrate metabolism emzimbeni, khona-ke kunethuba eliphezulu lokuthi ngemuva kokuhoxiswa kwemithi ebangele isifo sikashukela, lesi simo siyejwayelekile.
Izifo ezivusa inkanuko
Ngokuya ngohlobo lwesifo sikashukela, lesi sifo sabelwa ikhodi ngokuya nge-ICD 10. Uma sikhuluma ngefomu elincike ku-insulin, ikhodi izoba nge-E10. Ngefomu elizimele le-insulin, kunikezwa ikhodi i-E11.
Kwezifo ezithile, iziguli zingakhombisa izimpawu zesifo sikashukela. Enye yezimbangela ezivame kakhulu zokwakhiwa kwefomu lesi sifo yi-hypothalamic-pituitary disorder. Ukungasebenzi kahle ekusebenzeni kwe-hypothalamus kanye ne-pituitary gland kuyimbangela yokuvela kokungalingani kwama-hormone emzimbeni. Ngenxa yalokhu, amaseli awasaphenduli ku-insulin.
I-pathology ejwayelekile evusa ushukela yisifo sayo i-Itsenko-Cushing's. Ngalesi sifo emzimbeni kukhona ukukhiqizwa okukhuphukile kwe-hydrocortisone. Izizathu zokwakhiwa kwalesi sifo asikakaziwa, kepha kuvela:
- ekwelapheni i-glucocorticosteroids;
- nokukhuluphala;
- ngemuva kwesizinda sokudakwa ngokweqile (okungamahlalakhona);
- ngesikhathi sokukhulelwa;
- ngokumelene nesizinda sezifo ezithile ze-neurological nezengqondo.
Njengomphumela wentuthuko yesifo i-Itsenko-Cushing's, amaseli ayeka ukubona i-insulin. Kepha akukho ukungasebenzi kahle ekusebenzeni kwamanyikwe. Lokhu kungomunye umehluko omkhulu phakathi kwesimo se-steroid sikashukela nabanye.
Lesi sifo singakhula nasezigulini ezinobuthi (isifo samathuna, isifo iBazedova). Inqubo yokucubungula i-glucose kwezicubu iyaphazamiseka. Uma, ngokumelene nesizinda salezi zilonda ze-thyroid, isifo sikashukela sivele, khona-ke isidingo somuntu se-insulin sanda kakhulu, bese izicubu ziba namandla e-insulin.
Izimpawu zesifo
Ngesifo sikashukela se-steroid, iziguli azikhonondi ngokubonakala okujwayelekile kwesifo sikashukela. Cishe abanawo ukoma okungalawulwa, ukwanda kwesibalo sokuchama. Izimpawu ezithi abanesifo sikashukela bakhalaze ngesikhala sikashukela nazo azikho.
Futhi, ezigulini ezinesifo sikashukela se-steroid, azikho neze izimpawu ze-ketoacidosis. Ngesinye isikhathi, iphunga elibonakalayo le-acetone lingavela liphuma emlonyeni. Kepha lokhu kwenzeka, njengomthetho, kulezo zimo lapho lesi sifo sesivele sidlulile kwifomu elinganakiwe.
Izimpawu zesifo sikashukela se-steroid zingaba ngale ndlela elandelayo:
- ukwanda kwenhlala-kahle;
- ukubonakala kobuthakathaka;
- ukukhathala.
Kepha ushintsho olunjalo lungakhombisa izifo ezahlukahlukene, ngakho-ke odokotela kungenzeka bonke bangasoli ukuthi isiguli siqala isifo sikashukela. Iningi lingayi nakudokotela, likholelwa ukuthi kungenzeka ukubuyisela ukusebenza ngokuthatha amavithamini.
Isifo isifo
Ngokuqhubeka kwesifo se-steroid salesi sifo, amangqamuzana e-beta akhiwe kumanyikwe aqala ukulinyazwa isenzo se-corticosteroids. Okwesikhashana basakwazi ukukhiqiza i-insulin, kepha ukukhiqizwa kwayo kuyancipha kancane kancane. Ukuphazamiseka kwesimo se-metabolic kuvela. Izicubu zomzimba azisaphenduli i-insulin ekhiqizwayo. Kepha ngokuqhubeka kwesikhathi, ukukhiqizwa kwayo kuyeka ngokuphelele.
Uma ama-pancreas eyeka ukukhiqiza i-insulin, khona-ke lesi sifo sinezimpawu ezibonakalako zesifo sikashukela 1. Iziguli zinomuzwa wokoma kakhulu, ukwanda kwenani lokuchama nokwanda kokuphuma komchamo nsuku zonke. Kepha ukwehla okubukhali kwesisindo, njengakulezo ziguli ezinesifo sikashukela sohlobo 1, aziveli kuzo.
Lapho ukwelashwa nge-corticosteroids kudingekile, ama-pancreas abhekana nengcindezi enkulu. Izidakamizwa ngakolunye uhlangothi ziyayithinta, ngakolunye uhlangothi, kuholele ekwenqabeleni ukumelana ne-insulin. Ukuze ulondoloze isimo esijwayelekile se-pancreas, umuntu kufanele asebenze kuze kube semkhawulweni.
Isifo asitholakali ngaso sonke isikhathi noma ngabe sihlaziywa. Ezigulini ezinjalo, ukuhlangana noshukela egazini nasemizimbeni ye-ketone emchameni kuvamile.
Kwezinye izimo, ngenkathi uthatha izidakamizwa ze-glucocorticosteroid, isifo sikashukela siyanda, esasikade sivezwa kabi. Kulesi simo, ukuwohloka okubukhali kwesimo kungenzeka kufinyelele ku-coma. Ngakho-ke, kuyaluleka ukuthi uhlole ukugxila kwe-glucose ngaphambi kokuqala ukwelashwa kwe-steroid. Lesi sincomo sitshelwa ukuthi sihambisane nabantu abakhuluphele ngokweqile, izinkinga ezinomfutho wegazi. Zonke iziguli zeminyaka yokuthatha umhlalaphansi nazo kufanele zihlolwe.
Uma bekungekho zinkinga nge-metabolism ngaphambili, futhi inkambo yokwelashwa kwe-steroid ngeke ibe yinde, khona-ke isiguli kungenzeka singazi ngesifo sikashukela se-steroid. Ngemuva kokuphothula ukwelashwa, imetabolism ihlala ijwayelekile.
Amaqhinga okwelapha
Ukuqonda ukuthi ukwelashwa kwalesi sifo kwenziwa kanjani, imininingwane ku-biochemistry yezinqubo emzimbeni izovumela. Uma ushintsho lubangelwe yi-hyperproduction ye-glucocorticosteroids, khona-ke ukwelashwa kuhloselwe ukwehlisa inani labo. Kubalulekile ukuqeda izimbangela zalolu hlobo lwesifo sikashukela futhi wehlise noshukela oshukela. Lokhu kwalokhu, imishanguzo ye-corticosteroid ebekade ibekiwe ngaphambili ikhanseliwe.
Ngezinye izikhathi ngisho nokungenelela kokuhlinzwa kuyadingeka. Odokotela abahlinzayo basusa izicubu ze-adrenal ngokweqile. Lokhu kusebenza kukuvumela ukuthi unciphise inani lama-glucocotricosteroids emzimbeni futhi wenze isimo seziguli sibe ngokwejwayelekile.
I-Endocrinologists ingabeka ukwelashwa kwezidakamizwa okuhlose ukwehlisa amazinga kashukela. Kwezinye izikhathi kulungiselelwe ama-sulfonylurea. Kepha ngokumelene nesizinda sokudla kwabo, i-carbohydrate metabolism ingahle ikhule. Umzimba ngeke usebenze ngaphandle kokuvuselelwa okwengeziwe.
Uma isifo sikashukela sitholakala ngendlela engachazwanga, amaqhinga aphambili okwelapha ukuqedwa kwemithi edale lesi sifo, ukudla nokuzivocavoca. Ngokuya kulezi zincomo, isimo singenziwa silinganiswe ngokushesha okukhulu.
