Isifo sikashukela i-mellitus nama-antibodies kumaseli we-beta anobudlelwano obuthile, ngakho-ke uma usola isifo, udokotela angakunikeza lezi zifundo.
Sikhuluma ngama-autoantibodies umzimba womuntu awakha ngokumelene ne-insulin yangaphakathi. Ama-antibodies kuma-insulin isifundo esifundisayo nesinembile sohlobo 1 sikashukela.
Izinqubo zokuxilonga zezinhlobo zohlobo loshukela zibalulekile ekwenzeni i-phennosis nokwakha irejimeni yokwelashwa ephumelelayo.
Ukutholwa Kwehlukahluka Kwesifo Sikashukela Kusebenzisa Ama-antibodies
Kuhlobo lokuqala lwe-pathology, ama-antibodies ku-pancreatic zinthu akhiqizwa, okungekhona ukuthi ngesifo sohlobo 2. Ngohlobo 1 sikashukela, i-insulin idlala indima ye-autoantigen. Umuthi uqondile ngokuqinile kumanyikwe.
I-insulin yehlukile kwamanye ama-autoantigenyawa okulesi sifo. Isibonakaliso esivelele sokungasebenzi kahle kwe-gland kuhlobo 1 sikashukela singumphumela omuhle kuma-antibodies e-insulin.
Kulesi sifo, kunezinye izidumbu ezisegazini ezihlobene namaseli we-beta, ngokwesibonelo, amasosha omzimba ukulwa glaramylase decarboxylase. Kunezici ezithile:
- I-70% yabantu inama-antibodies amathathu noma ngaphezulu,
- ngaphansi kuka-10% banenhlobo eyodwa,
- awekho ama-antibodies ku-2-4% weziguli.
Ama-antibodies kuma-hormone kushukela awabhekwa njengembangela yokwakheka kwalesi sifo. Zibonisa kuphela ukubhujiswa kwezakhi zamaseli e-pancreatic. Ama-antibodies kuma-insulin ezinganeni ezinesifo sikashukela kungenzeka kakhulu kunasebudaleni.
Imvamisa ezinganeni ezinesifo sikashukela esinohlobo lokuqala lokugula, amasosha omzimba wokuvikela i-insulin avela kuqala futhi ngamanani amakhulu. Lesi sici sibonisa izingane ezingaphansi kweminyaka emithathu ubudala. Ukuhlolwa kwe-antibody manje kuthathwa njengokuvivinya okubonisa kakhulu ukuthola ukuthi ngubani onoshukela abancane.
Ukuthola inani lemininingwane ephezulu, kuyadingeka ukuqoka hhayi ucwaningo olunjalo kuphela, kodwa futhi nokutadisha ubukhona bezinye izinhlaka ze-autoantibodies of pathology.
Ucwaningo kufanele lwenziwe uma umuntu enezimpawu ze-hyperglycemia:
- ukukhuphuka kwenani lomchamo
- ukomela okukhulu nokuthambekela okuphakeme,
- ukunciphisa umzimba ngokushesha
- ukwehla kwamandla okubuka,
- ukuncipha kokuzwela komlenze.
Ama-insulin antibodies
Ukuhlolwa kwe-insulin antibody kukhombisa ukulimala kwe-beta-cell ngenxa yengozi eyenzelwa ifa. Kunama-antibodies kuma-insulin angaphandle nangaphakathi.
Ama-antibodies entweni yangaphandle akhombisa ubungozi bokungezwani ne-insulin enjalo kanye nokuvela kokungamelana ne-insulin. Kusetshenziswa isifundo lapho amathuba wokunquma ukwelashwa kwe-insulin esemncane, kanye nokwelashwa kwabantu abanamathuba akhulayo okuthola isifo sikashukela.
Okuqukethwe ama-antibodies lawo akufanele kube ngaphezulu kune-10 U / ml.
Ama-antibodies ama-glutamate ama-decarboxylase (GAD)
Kusetshenziselwa ucwaningo kuma-antibodies kuya ku-GAD ukuthola isifo sikashukela lapho isithombe somtholampilo singaziwa futhi isifo sifana nohlobo 2. Uma ama-antibodies ku-GAD enqunywa kubantu abangaxhomekeki kwe-insulin, lokhu kubonisa ukuguqulwa kwesifo kube ifomu elincike ku-insulin.
Ama-antibodies e-GAD nawo angavela eminyakeni eminingana ngaphambi kokuqala kwesifo. Lokhu kukhombisa inqubo ye-autoimmune ebhubhisa amaseli we-beta wesikhumba. Ngaphezu kwesifo sikashukela, ama-antibodies anjalo angaxoxa, okokuqala, mayelana:
- lupus erythematosus,
- isifo samathambo.
Ubungako obukhulu be-1.0 U / ml baziwa njengesibonakaliso esejwayelekile. Umthamo omningi wama-antibodies angakhombisa isifo sikashukela sohlobo 1, futhi ukhulume ngobungozi bokwenza izinqubo ze-autoimmune.
I-peptide
Kuyinkomba yokufihlwa kwe-insulin yakho. Ibonisa ukusebenza kwamaseli we-pancreatic beta. Lolu cwaningo luhlinzeka ngemininingwane ngisho nokujova kwangaphandle kwe-insulin nangama-antibodies akhona ku-insulin.
Lokhu kubaluleke kakhulu ocwaningweni lwabanesifo sikashukela ngohlobo lokuqala lokugula. Ukuhlaziywa okunjalo kunikeza ithuba lokuhlola ukunemba kohlobo lwe-insulin therapy regimen. Uma kungekho-insulin ngokwanele, khona-ke i-C-peptide izokwehliswa.
Ucwaningo lunqunyiwe ezimweni ezinjalo:
- uma kunesidingo ukuhlukanisa uhlobo 1 bese uthayipha 2 isifo sikashukela,
- ukuhlola ukusebenza ngempumelelo kwe-insulin therapy,
- uma usola i-insulin
- ukusebenzisa ukulawula isimo somzimba nge-pathology yesibindi.
Umthamo omkhulu we-C-peptide ungaba no:
- isifo sikashukela esinga-insulin,
- ukwehluleka kwezinso
- ukusetshenziswa kwama-hormone, njengezindlela zokuvimbela inzalo,
- insulinoma
- I-hypertrophy yamaseli.
Amanani ancishisiwe e-C-peptide akhombisa isifo sikashukela esincike ku-insulin, kanye:
- I-hypoglycemia,
- izimo ezicindezelayo.
Izinga lijwayelekile kububanzi ukusuka ku-0,5 kuye ku-2.0 μg / L. Ucwaningo lwenziwa esiswini esingenalutho. Kufanele kube nesikhathi sokuphumula samahora ayi-12. Amanzi ahlanzekile avumelekile.
Ukuhlolwa kwegazi kwe-insulin
Lesi isivivinyo esibalulekile sokuthola uhlobo lwesifo sikashukela.
Nge-pathology yohlobo lokuqala, okuqukethwe kwe-insulin egazini kwehliswa, futhi nge-pathology yohlobo lwesibili, umthamo we-insulin uyakhuphuka noma uhlala uvamile.
Lolu cwaningo lwe-insulin yangaphakathi lusetshenziselwa nokusola izimo ezithile, sikhuluma ngalokhu:
- i-acromegaly
- isifo se-metabolic
- insulinoma.
Umthamo we-insulin ebangeni elijwayelekile ngu-15 pmol / L - 180 pmol / L, noma 2-25 mced / L.
Ukuhlaziywa kwenziwa ngesisu esingenalutho. Kuvunyelwe ukuphuza amanzi, kepha okokugcina umuntu kufanele adle amahora angu-12 ngaphambi kwesifundo.
IGlycated Hemoglobin
Le yinhlanganisela ye-molecule yeglue ene-molecule ye-hemoglobin. Ukunqunywa kwe-hemoglobin ye-glycated kunikeza idatha esezingeni eliphakathi noshukela ezinyangeni ezi-2 noma ezi-3 ezedlule. Imvamisa, i-glycated hemoglobin inenani le-4 - 6.0%.
Umthamo owengeziwe we-hemoglobin ye-glycated ukhombisa ukungasebenzi kahle emzimbeni we-carbohydrate uma isifo sikashukela sitholwa kuqala. Futhi, ukuhlaziya kukhombisa isinxephezelo esinganele necebo lokwelashwa elingafanele.
Odokotela balule abantu abanesifo sikashukela ukuthi benze lolu cwaningo izikhathi ezine ngonyaka. Imiphumela ingahle ihlanekezelwe ngaphansi kwemibandela nezinqubo ezithile, okungukuthi lapho:
- ukopha
- ukumpontshelwa igazi
- ukuntuleka kwensimbi.
Ngaphambi kokuhlaziywa, ukudla kuvunyelwe.
I-Fructosamine
Iprotheni ye-glycated noma i-fructosamine yinhlanganisela ye-molecule yeglue ene-molecule yamaprotheni. Isikhathi sokuphila salezi zinhlanganisela sicishe sibe ngamaviki amathathu, ngakho-ke i-fructosamine ikhombisa inani eliphakathi kashukela emavikini ambalwa edlule.
Amanani we-fructosamine ngamanani ajwayelekile kusuka ku-160 kuye ku-280 μmol / L. Ezinganeni, okufundwayo kuzoba ngaphansi kunokwabantu abadala. Umthamo we-fructosamine ezinganeni uvame ukuba ngu-140 kuye ku-150 μmol / L.
Ukuhlolwa komchamo we-glucose
Kumuntu ongenazo i-pathologies, ushukela kufanele ungabi khona emchini. Uma kuvela, lokhu kukhombisa ukuthuthuka, noma isinxephezelo esanele seshukela. Ngokwanda kweshukela egazini nokuntuleka kwe-insulin, ushukela owedlulele awudalulwa kalula yizinso.
Le nto ibonwa ngokwanda komkhawulo we- “renal thows”, okuyisilinganiso sikashukela egazini, lapho iqala ukuvela khona emchameni. Izinga "lomkhawulo wezinso" lilodwa, kepha, kaningi, lisebangeni le-7.0 mmol - 11.0 mmol / l.
Ushukela ungabonakala kumthamo owodwa womchamo noma kumthamo wansuku zonke. Esimweni sesibili, lokhu kwenziwa: inani lomchamo lithululelwa esitsheni esisodwa phakathi nosuku, khona-ke umthamo ulinganiswa, uxutshwe, bese ingxenye yokuqukethwe ingena esitsheni esikhethekile.
Ushukela ngokuvamile akufanele ube ngaphezulu kuka-2.8 mmol kumchamo wansuku zonke.
Ukuhlolwa kokubekezelela kwe-glucose
Uma kutholakala izinga elikhudlwana le-glucose egazini, kuhlolwa isivinini sokubekezelela ushukela. Kuyadingeka ukukala ushukela esiswini esingenalutho, khona-ke isiguli sithatha u-75 g we-glucose oxutshiwe, bese kwenziwa isifundo sesibili (ngemuva kwehora namahora amabili kamuva).
Ngemuva kwehora, umphumela ngokuvamile awufanele ube ngaphezulu kuka-8.0 mol / L. Ukwanda kwe-glucose kuya ku-11 mmol / L noma ngaphezulu kubonisa ukukhula kwesifo sikashukela kanye nesidingo sokwenza okwengeziwe.
Uma ushukela uphakathi kuka-8,0 no-11,0 mmol / L, lokhu kukhombisa ukungabekezeleli kwe-glucose. Isimo lesi siyisidambisi sikashukela.
Imininingwane yokugcina
Isifo sikashukela sohlobo loku-1 sibonisa izimpendulo zokuzivikela komzimba ngokumelene nezicubu ze-pancreatic cell. Umsebenzi wezinqubo ze-autoimmune uhlobene ngqo nokuqoqwa nenani lama-antibodies athile. La masosha omzimba avela kudala ngaphambi kokuvela kwezimpawu zokuqala zesifo sikashukela sohlobo 1.
Ngokuthola amasosha omzimba, kungenzeka ukuhlukanisa phakathi kwesifo sikashukela sohlobo 1 nohlobo 2, kanye nokuthola isifo sikashukela se-LADA ngesikhathi esifanele). Ungenza ukuxilongwa okulungile kusenesikhathi bese wethula ukwelashwa kwe-insulin okudingekile.
Ezinganeni nakubantu abadala, kutholakala izinhlobo ezahlukene zamasosha omzimba. Ukuhlolwa okuthembeke ngokwengeziwe kwengozi yesifo sikashukela, kuyadingeka ukuthola zonke izinhlobo zama-antibodies.
Muva nje, ososayensi bathole i-autoantigen ekhethekile okwakhelwa kuyo amasosha omzimba kuhlobo lwesifo sikashukela. It is a transporter ye-zinc ngaphansi kwe-ZnT8 Idlulisela ama-athomu we-zinc kumaseli we-pancreatic, lapho ebamba iqhaza khona ekugcineni kwe-insulin engasebenzi.
Ama-antibodies ku-ZnT8, njengomthetho, ahlanganiswa nezinye izinhlobo zama-antibodies. Ngohlobo lokuqala lwe-1 mellitus yesifo sikashukela esitholakele, amasosha omzimba ku-ZnT8 akhona ku-65-80% yamacala. Cishe ama-30% abantu abanesifo sikashukela sohlobo loku-1 nokungatholakali kwezinye izinhlobo ezine ze-autoantiody ezine-ZnT8.
Ukuba khona kwabo kuwuphawu lokuqala kokuqala kwesifo sikashukela sohlobo 1 nokuntuleka kwe-insulin yangaphakathi.
Ividiyo ekulesi sihloko izotshela ngomgomo wokusebenza kwe-insulin emzimbeni.
