Ukuhlolwa kwegazi elabhorethri kusiza ngesikhathi esifushane futhi kuncike kakhulu ekuthembekeni kokuba khona kwezifo ezimbi emzimbeni womuntu futhi kunqume ukwelashwa okufanele. Abaningi besifo sikashukela bayazi ucwaningo olufana nokuhlolwa kwegazi kwe-glycated hemoglobin.
IHemoglobin yiprotheni ekhethekile, iyingxenye yamaprotheni ezinto eziphilayo anesistimu yokujikeleza. Ukuhlanganiswa kwamangqamuzana komoya-mpilo, i-hemoglobin iyiletha emangqamuzaneni egazi, ibamba iqhaza ekukhutshweni kwekhabhoni dayokisi kusuka ezicutshini. Namuhla, izinhlobo eziningana ze-hemoglobin ziyaziwa, i-hemoglobin A predominates phakathi kwazo, ifinyelela cishe ku-95% wayo yonke i-hemoglobin esegazini. I-hemoglobin yona ihlukaniswe izakhi, enye yazo ibizwa nge-A1c.
Izibopho ezingeke ziguqulwe zakhiwa ku-hemoglobin ene-glucose, odokotela babiza le nqubo ngokuthi ukusabela kukaMaillard, i-glycation noma i-glycation. Ngakho-ke, uma i-hemoglobin ihlangana ne-glucose, ibizwa ngokuthi i-glycated. I-Endocrinologists ibheka le nto njengomsizi oyinhloko ekuhlolweni kwesifo sikashukela kanye nokunye ukuphazamiseka kwe-carbohydrate metabolism.
Ukwehlisa izinga likashukela wegazi, kunciphisa inqubo ye-glycation. Isikhathi esijwayelekile somsebenzi weseli elibomvu cishe sinezinyanga ezintathu, okungukuthi, ungalandelela izinga le-glucose esegazini kuphela ngalesi sikhathi. Ngamanye amagama, ukuhlaziywa kwe-hemoglobin ye-glycated kuwuhlobo lwesikhombi se-degree "okuqukethwe ushukela" kwegazi.
Ngubani otuswa ukuba ahlaziye
Ucwaningo nge-glycohemoglobin luyadingeka ukuthola inani likashukela emzimbeni womuntu ezinsukwini ezingama-120 ezedlule. Ukuhlaziywa kungabizwa ngokuthi kwembula kakhulu phakathi kwezinye izindlela zokuhlola amazinga egazi we-glycemia. Kuyinto efundisayo ukwedlula ukuhlolwa kwegazi okusheshayo, okukhombisa isimo somzimba kuphela ngesikhathi esithile - ngesikhathi sokuqoqwa kwezinto eziphilayo.
Kunenkambiso efakiwe ngokwesayensi ye-glycated hemoglobin yabantu abangenawo umlando wesifo sikashukela, uma kwenzeka ukuphazamiseka kwe-metabolic lokhu kuvama kudlula kaningana. Izinga le-glycation likhuphuka kakhulu, kuphakama izinga lokuhlaselwa koshukela ezinyangeni ezimbalwa ezedlule. Kulokhu, amathuba okuthuthuka kwezinkinga zesifo sikashukela ayanda.
Ukuhlaziywa kwe-glycated kuyadingeka ekuhlolweni okwanele kwekhwalithi yezidakamizwa ezisetshenziswayo, lapho i-glycogemoglobin inganciphi, kuhlelwe ukuthi kulungiswe irejimeni yokwelashwa, ithathe indawo yemithi enconyiwe, futhi kubuyekezwe ukudla.
Izinkomba eziphambili zokuhlaziywa kwe-glycogemoglobin:
- isidingo sokuxilongwa, ukuhlolwa kwesifo sikashukela;
- ukuqaphela isikhathi eside ikhwalithi yokunakekelwa kwesifo sikashukela;
- ukuxilongwa okuphelele kwabesifazane abakhulelwe ukungafaki isifo sikashukela;
- isidingo sedatha ethe xaxa.
Ukuze umphumela wokuhlolwa kwegazi uthembeke, kuyadingeka ukuthi usondele ekulethweni kwawo nangawo wonke umthwalo, ukulungiselela kahle.
Ilungiselela ukuhlolwa
Lapho udokotela ohambelayo kufanele ahlole izinkomba ze-glycemia, alungise ukwelashwa okunconyiwe, uyalela isiguli ekuhlolweni kwegazi. Nikeza assay gogcin hemoglobin, khombisa HbA1c ohlangothini.
Uma okunye ukuhlolwa kweshukela kudingeka kuthathwe esiswini esingenalutho, igazi le-hemoglobin ye-glycated livunyelwe ukuthathwa nganoma yisiphi isikhathi sosuku, akunandaba nakancane ukuthi isiguli sikudlile yini ukudla noma cha. Lokhu akunamthelela enkombeni ye-glycemic.
Intengo ephakathi yokuhlaziywa isuka kuma-ruble angama-300 kuya kwayi-1200 ama-ruble aseRussia; Ezweni lethu, ezikhungweni zezokwelapha zikahulumeni, imishini ekhethekile yokuhlaziya ngokuvamile ayitholakali.
Isampula yegazi ithathwa emthanjeni we-cubital; i-3 ml yegazi lesiguli yanele ukuthola ukuxilongwa. Kwezinye iziguli, ukunikela ngegazi elinjalo kungaba yinkinga:
- baqala ukuzizwa benesiyezi;
- isicanucanu somusa siyabonakala.
Ngakho-ke, isiguli kufanele sixwayise umsizi waselebhu ukuthi kungadingekile ukuba ne-ammonia ekhona.
Uma ngosuku lokuqala kokuhlaziywa kwe-hemoglobin ye-glycated, umuntu enovalo, edla imishanguzo ebekiwe, lokhu ngeke kuwuthinte umphumela. Noma kunjalo, izimo ezicindezelayo azikwazi ukuwahlukanisa ngokuphelele amaphutha namaphutha wokuhlaziya. Ukulahleka okukhulu kwegazi, ukuya esikhathini esindayo, ukuzala kwengane kanye ne-hemolytic anemia kungathinta idatha etholakele.
Noma ngabe ngasizathu simbe isiguli sifuna "ukulungisa" umphumela kumanani ajwayelekile, akunangqondo ukuthi kunamathela ekudleni okushukela omncane osezingeni eliphansi, ngoba lokhu ngeke kuthinte ukwakheka kwegazi nganoma iyiphi indlela.
Ungalungiselela kanjani? Ukuqeqeshwa okukhethekile okhethekile akunikezwanga, kufanele unamathele ekudleni kwakho okujwayelekile, uhlanganyele nokuzivocavoca ngokomzimba.
Ukuhlaziywa kwenzelwa i-hemoglobin ye-glycated cishe izinsuku ezintathu, ukuthi kuthatha isikhathi esingakanani, futhi izindleko zokufunda zincike elabhorethri, imishini yayo yezobuchwepheshe.
Uyini umkhuba umuntu ophilile
Kala igazi glycogemoglobin lithathwa njengephesenti noma g / mol. Udinga ukwazi ukuthi i-glycosylated hemoglobin nayo ikhona egazini labantu abaphilile ngokuphelele, imingcele yayo isuka ku-4 iye ku-6%. Ibanga eliqanjiwe lilungile kubantu kungakhathalekile ngobudala nangokobulili. Noma yikuphi ukuphambuka kubhekwa njengokuphula umthetho.
Lapho umphumela utholakala ebangeni ukusuka ku-5.7 kuye ku-6.5%, ukwephula ukumelana noshukela, kutholakala amathuba esifo sikashukela. Zonke izinamba ezingaphezulu kuka-6.5% zikhombisa ukukhula kwesifo sikashukela.
Kuncike ekutheni umuntu akazange athole isifo sikashukela ngaphambili, ukuhlolwa kwe-hemoglobin ye-glycated kuyadingeka uma omunye wezihlobo zegazi enesifo se-metabolic. Lokhu kuzovumela ukukhonjwa okufika ngesikhathi kwezinkinga zezempilo, qala ukwelashwa ukuvimbela izinkinga.
Ngesikhathi sokukhulelwa, abesifazane bahlolwa i-glycosylated hemoglobin ukuze bangafaki isifo sikashukela sokukhulelwa, lokhu kubalulekile noma kungekho zinkinga:
- ngomzimba;
- noshukela omkhulu wegazi.
Isifo sikashukela sokukhulelwa siyindlela ekhethekile yesifo sikashukela, abesifazane abakhulelwe bathola lesi sifo. Odokotela bahlobanisa izimbangela zokuthuthuka kwe-pathology nokwakhiwa kabusha kwe-hormonal komzimba, umthwalo owengeziwe kwizitho zangaphakathi kanye nama-pancreas.
I-placenta ikhiqiza ama-hormone, umgomo wabo wokusebenza uphikisana nemiphumela ye-insulin, ngenxa yalokho, ukuphazamiseka kwe-metabolic kwenzeka kumama nengane.
Engcupheni abesifazane abakhulelwe abanesifiso sokuba nesifo sikashukela, amazinga ahlukahlukene okukhuluphala, i-polyhydramnios, i-polycystic ovary syndrome, ingane ezelwe emlandweni.
Noma kunjalo, ukuhlolwa kwegazi okunjalo ngoshukela kunqunyelwe kuyaqabukela, kuvame kakhulu Kunconywa ukunikela ngegazi ukumelana noshukela.
Izinhlobo ze-glycogemoglobin zesifo sikashukela, izimbangela zokuphambuka
I-diabetes mellitus iyindlela yokusebenza kohlelo lwe-metabolic yomuntu; ibonakala ngoshintsho emazingeni kashukela wegazi kanye nokwanda kokuhlushwa kwalo. Lesi sifo singasukela ekuqhekeni okunganele kwe-insulin ye-hormone, i-polyuria, izinguquko kumaminerali noma emafutheni amaningi.
Izimbangela zesifo sikashukela kufanele zifunwe esikhathini esidlule izifo ezithathelwanayo ezinzima, ukukhuluphala, ifa elibi, ukulimala kwengqondo, isimila se-pancreas. Ngokuya imvamisa yokuvela kwalesi sifo, isendaweni yesithathu ngemuva kwe-oncology nezifo zohlelo lwenhliziyo. Isifo sikashukela sithambekele kakhulu kwabesifazane abaneminyaka engaphezu kwengama-40.
Ukunyuka kwe-hemoglobin ye-glycosylated kubhekwa lapho umbhalo wokuhlaziya ukhombisa izinombolo ukusuka ku-5.9 kuye ku-6%. Nge-mellitus yesifo sikashukela eqinisekisiwe, inkomba efanelekile ingu-6.5%, ukukhuphuka okufika ku-8% noma ngaphezulu kukhombisa ukungasebenzi kahle kwezokwelapha ezisetshenzisiwe, isidingo sokulungiswa kwempilo. Ukuqokwa kwe-glycogemoglobin ngaphezu kwe-12% kuyingozi, okusho ukuthi ukulaliswa esibhedlela okuphuthumayo esikhungweni sezokwelapha.
Njengoba umkhuba ukhombisa, kude nazo zonke iziguli, izinga le-hemoglobin ye-glycated lifinyelela ezingeni le-6.5%, kwezinye izimo lihle kakhulu uma kutholakala inkomba ephakeme kakhulu. Isibonelo, lo mthetho ubalulekile ezigulini esezikhulile ezinezifo ezihlangabezana nazo. Ngama-glycogemoglobin ancishisiwe, angaqala i-hypoglycemia nazo zonke izingqinamba nokuphazamiseka okulandelayo.
Kufanele wazi ukuthi i-mellitus yesifo sikashukela sokuqala noma sesibili akuyona imbangela yoshintsho ezivivinyweni ze-glycosylated hemoglobin. Kaningi, ukuhlolwa kukhombisa izinga lokukhuphuka kwe-glycation ezinkingeni ezinjalo zezempilo:
- ukwehluleka kwezinso okulimazayo futhi okungamahlalakhona;
- izinguquko zomsebenzi we-pancreatic;
- ukuntuleka kwe-iron anemia;
- ukuhlinzwa ukuze kususwe i-spleen.
Uma i-glycosylated hemoglobin iphakanyisiwe enganeni ezinyangeni zokuqala zokuphila, lokhu kuyinto evamile. Ngominyaka, i-hemoglobin ye-fetus ivame ukuncishiswa.
Ukuhlolwa okubanzi komzimba wesiguli kusiza ukuthola izizathu ngqo zoshintsho ekugxambeni kwe-glucose egazini, kufanele kuqalwe ngokushesha.
Izimbangela ze-glycogemoglobin encishisiwe
Kuyiphutha ukukholelwa ukuthi yi-hemoglobin ephakeme kuphela eyingozi. Ukwehla kwalesi sakhi nakho kuwubufakazi bokuphazamiseka emzimbeni, yize le nto itholakala ingajwayelekile.
Ukwehla kwe-hemoglobin ye-glycated kungenzeka ngenxa ye-hypoglycemia yesikhathi eside, ukucasha ngokweqile kwamangqamuzana abomvu egazi (amaseli abomvu egazi) emzimbeni ngokuntuleka kohlelo lwe-hematopoietic. Ngaphezu kwalokho, izinombolo eziphansi zihambisana nokulahleka kwegazi kwakamuva, ngemuva kokuhlinzwa nokulimala.
Kwenzeka ukuthi ushintsho ekuhlushwa ushukela lubangelwa yisifo lapho amaseli abomvu egazi (i-hemolytic anemia) ebhujiswa, ngokuhluleka kwesibindi nezinso, ama-pathologies we-pancreas.
Ukuboniswa kwamazinga kashukela aphansi (lesi simo sibizwa nangokuthi i-hypoglycemia ku-mellitus yesifo sikashukela) kungaba nezimpawu ezahlukahlukene, phakathi kwazo:
- ukungaboni kahle;
- ukusebenza ngokweqile;
- ukozela
- izimo zokwehluleka;
- ukuphazamiseka kwemizwa.
Ezimweni ezinzima kakhulu, umphumela obulalayo awubandakanywa, ngakho-ke, udinga ukunikela ngegazi ngezikhathi ezithile ukuze ucwaningwe, ukwazi ukuthi lokho kuhlaziywa kutshengiswa kanjani, ukunikela kanjani ngokufanele, okufanele ukwenze ukuthuthukisa inhlala-kahle yakho.
Ungayinciphisa kanjani i-glycated hemoglobin
Ukwehla kwezinga le-hemoglobin ye-glycated kuhlobene ngqo nokwehla kokuxineka koshukela egazini, uma i-glucose ijikeleza egazini kancane, khona-ke inkomba ye-glycemic hemoglobin izophansi.
Ukuze ulethe i-hemoglobin A ibe yinto evamile, kuyadingeka ukulandela njalo imiyalo kadokotela, ukufeza yonke imininingwane yayo. Okokuqala, umthetho ukunamathela ekudleni okuphansi kwe-carb (ukudla kuyabiliswa, kubhakwe noma kubilisiwe), irejimeni ekhethekile yokulala, umsebenzi nokuphumula.
Kubalulekile ukungawunaki ukuzivocavoca umzimba njalo, uphuze umuthi onqunyelwe ngesikhathi, uphuze nemijovo ye-insulin. Zonke izinsuku udinga ukuzihlola ushukela, ekhaya udinga ukuba ne-glucometer enhle, wazi ukuthi ungayithatha kanjani, yini okufanele ibe yisampula yezinto ezithathiwe, ukuthi ushukela wegazi ukhonjiswa kanjani. Ama-glucometer anamuhla namawashi abathola isifo sikashukela bahlaziya igazi kumasekhondi ambalwa.
Kufanele futhi uvakashele uhlelo lwakho lodokotela. Uma ukuhlaziywa kudluliswa ngokuya ngayo yonke imithetho, lokhu kukuvumela ukuthi uhlole ushukela ngaphandle kwamaphutha futhi uthathe isenzo uma kunesidingo.
Ungakuhlaziya kanjani i-hemoglobin ye-glycated uzotshela uchwepheshe kuvidiyo ekulesi sihloko.
