Ukwelashwa kwesifo sikashukela kwenziwa kusetshenziswa izidakamizwa ezingathi, uma zingakhiqizi ukukhiqizwa kwe-hormone yazo (i-insulin), zinganciphisa i-glycemia ephezulu futhi zivikele nezinkinga zesifo.
Yonke imishanguzo ingahlukaniswa ngamaqembu amabili ayinhloko: ama-insulin ezinsuku ezihlukene zomsebenzi nezidakamizwa ezibekwa etafuleni. Ngohlobo lokuqala lwesifo sikashukela, iziguli zidinga i-insulin, ukwelashwa kweziguli ezinesifo sikashukela sohlobo 2 kubandakanya ukufakwa kwayo ekwelashweni okuhlanganisiwe lapho kukhona izinkomba ngazinye.
Ukuthatha i-insulin therapy kuzala kabusha isigqi semvelo sokukhiqizwa nokukhululwa kwe-hormone kusuka kumaseli we-islet ama-pancreas, ngakho-ke, izidakamizwa ezinesinyathelo esifushane, esiphakathi neside ziyadingeka.
Ngabe isebenza kanjani i-insulin nge-protamine?
Umuthi okhethekile obizwa ngokuthi yi-protamine ungezwa kumamoya osebenza okuphakathi ukuze unciphise ukutholwa komuthi endaweni yomjovo. Ngenxa ye-protamine, ukuqala kokwehla kweshukela egazini kuqala amahora amabili noma amane ngemuva kokuphathwa.
Umphumela omkhulu wenzeka ngemuva kwamahora angama-4-9, futhi sonke isikhathi sisuka emahoreni ayi-10 kuye kwayi-16. Amapharamitha anjalo wesilinganiso sokuqala komphumela we-hypoglycemic enza ukuthi kungenzeka ukuthi ama-insulin afake okunye esikhundleni secretion yemvelo ye-basal.
I-Protamine idala ukwakheka kwamakristalu e-insulin ngendlela yama-flakes, ngakho-ke ukubonakala kwe-protulin insulin kunamafu, futhi wonke amalungiselelo ama-insulin amafushane abonakala. Ukwakheka kwalesi sidakamizwa kufaka ne-zinc chloride, sodium phosphate, phenol (gcina) kanye ne-glycerin. Umamililitha owodwa wokumiswa kwe-protamine-zinc-insulin uqukethe ama-PIERES angama-40 ama-hormone.
Ukulungiswa kwe-protamine insulin ekhiqizwe i-Rue Belmedpreparaty kunegama lokuthengisa elithi Protamine-Insulin ChS. Indlela yokusebenza yalesi sidakamizwa ichazwa yimiphumela enjalo:
- Ukuxhumana ne-receptor kulwelwesi lweseli.
- Ukwakheka kwe-insulin receptor tata.
- Emangqamuzaneni esibindi, izicubu nezicubu ze-adipose, ukuqalwa kwama-enzyme kuqala.
- I-glucose iyangenwa futhi idonswe izicubu.
- Ukuhamba kwe-glucose ye-Intracellular kuyasheshiswa.
- Ukwenziwa kwamafutha, amaprotheni ne-glycogen kuyakhuthaza.
- Esibindi, ukwakheka kwama-molecule amasha eglucose kuyancipha.
Zonke lezi zinqubo kuhloswe ngazo ukwehlisa izinga le-glucose egazini futhi ulisebenzise ukukhipha amandla ngaphakathi esitokisini. Izinga lokuqalwa nesikhathi ubude besenzo seProtamine insulin ES kuncike kumthamo olungiselelwe, indlela kanye nendawo yomjovo.
Kumuntu ofanayo, lamapharamitha angahluka ngezinsuku ezihlukile.
Izinkomba zokusetshenziswa nomuthi womuthi
Ukulungiswa kwe-Protamine-zinc-insulin kuboniswa ezigulini zohlobo lokuqala lwe-mellitus yesifo sikashukela, kungabuye kunconyelwe i-glucose ephezulu yegazi ohlotsheni lwesibili lwesifo.
Lokhu kungamelana nokumelana namathebulethi ukwehlisa ushukela wegazi, ngokungezelelwa kwezifo ezithathelanayo noma ezinye izifo ezihlangene, kanye nangesikhathi sokukhulelwa. Iziguli ezinesifo sikashukela sohlobo 2 zibuye zidluliselwe ekwelashweni kwe-insulin uma isifo sikashukela sihambisana nezinkinga ezinzima noma ukuphazamiseka kwemithambo yegazi.
Izidakamizwa ezifana ne-protamine-zinc-insulin zikhonjiswa uma kudingekile ukuhlinzwa, uma kutholakala kuqala isifo sikashukela, kanti izinombolo ze-glycemia ziphezulu ngokweqile noma uma kukhona amaphikisi.
I-ES protamine-insulin ilawulwa ngokungaziphathi kahle, umthamo wayo uncike ezinkombeni ze-hyperglycemia ngamanye futhi ibalwa ngokwesilinganiso nge-1 kg yesisindo somzimba. Ukuphathwa kwansuku zonke kusuka ku-0,5 kuya ku-1 iyunithi.
Izici zesidakamizwa:
- Iphathwe yodwa kuphela ngokungahambi kahle. Ukuphathwa kwe-Intravenous kokumiswa kwe-insulin akuvunyelwe.
- Ibhodlela elivaliwe ligcinwa esiqandisini, futhi lapho lisetshenziswa emazingeni okushisa afinyelela kuma-25 degrees ngamaviki ayi-6.
- Gcina i-insulin vial esetshenzisiwe ekushiseni kwegumbi (kufika ku-25 ° C) amasonto ayi-6.
- Ukushisa kwe-insulin ngesingeniso kufanele kube lokushisa kwekamelo.
- Ngaphansi kwethonya lokushisa, ukukhanya kwelanga okuqondile, iqhwa, i-insulin ilahlekelwa izakhiwo.
- Ngaphambi kokuphatha i-protamine, i-zinc insulin kumele ifakwe ezintanjeni ize ibushelelezi futhi kunamafu. Uma lokhu kungenakwenziwa, isidakamizwa asikenziwa.
Indawo yomjovo ingakhethwa ngokuya ngesifiso sesiguli, kepha kufanele kukhunjulwe ukuthi iyamunca ngokulinganayo futhi kancane kancane ukusuka ethangeni. Indawo yesibili enconyiwe yindawo yamahlombe (izicubu zomsipha). Isikhathi ngasinye lapho udinga ukukhetha indawo entsha ngaphakathi komkhakha ofanayo we-anatomical ukugwema ukubhujiswa kwezicubu ezithambile.
Uma isiguli sinqunywa uhlobo olunamandla lokuphathwa kwe-insulin, khona-ke ukuphathwa kwe-protamine zinc insulin kwenziwa ekuseni noma kusihlwa, futhi lapho kukhonjisiwe, kabili (ekuseni nakusihlwa). Ngaphambi kokudla, kusetshenziswa uhlobo olufushane lwe-insulin.
Ohlelweni lwesibili lwesifo sikashukela, kuvame ukwenziwa i-Protamine-insulin ES ihlanganiswe nezidakamizwa ze-glypoglycemic, ezibekelwe ukuphathwa komlomo, ukuthuthukisa umphumela wazo.
Izinkinga zokwelashwa kwe-Insulin
Ukuphazamiseka okuvame kakhulu ukwelashwa kwe-insulin ukwehla kwamazinga kashukela egazini ngaphansi kwamazinga ajwayelekile. Lokhu kusizwa ukungondleki kahle ngenani eliphansi lama-carbohydrate nethamo eliphezulu le-insulin, ukweqa ukudla, ukucindezela ngokomzimba, ukuguqula indawo yomjovo.
I-Hypoglycemia idalwa izifo ezifanayo, ikakhulukazi lezo ezinomkhuhlane omkhulu, isifo sohudo, ukugabha, kanye nokuphatha ngokubambisana kwezidakamizwa ezithuthukisa isenzo se-insulin.
Ukuqala okungazelelwe kwezimpawu ze-hypoglycemia kujwayelekile ekwelashweni kwe-insulin. Imvamisa, iziguli zizizwa zinomuzwa wokukhathazeka, isiyezi, ukujuluka okubandayo, izandla eziqhaqhazelayo, ubuthakathaka obungavamile, ikhanda nekhanda.
Isikhumba siphuzi, indlala iyanda ngasikhathi sinye njengoba kwenzeka isicanucanu. Lapho-ke ukwaziwa kuyaphazamiseka bese isiguli siwela ekhefini. Ukwehla okwenziwe ushukela wegazi kuphazamisa ubuchopho futhi uma kungalashwa, iziguli zisengozini yokufa.
Uma isiguli esinesifo sikashukela sikhumbula, ungakhulula ukuhlaselwa usebenzisa ushukela noma ujusi omnandi, amakhukhi. Ngezinga eliphakeme le-hypoglycemia, isisombululo seglue egxiliwe kanye ne-glucagon ye-intramus kuphathwa ngaphakathi. Ngemuva kokuthuthukisa inhlala-kahle, isiguli kufanele sidle nakanjani ukuze kungabikho ukuhlaselwa okuphindaphindiwe.
Ukukhetha umthamo ongafanele noma ukuphathwa okuphuthelwe kungadala ukuhlaselwa kwe-hyperglycemia kwiziguli ezithembele ku-insulin. Izimpawu zalo zanda kancane kancane, isimilo esibonakalayo ukubonakala kwazo kungakapheli amahora ambalwa, kwesinye isikhathi kuze kufike ezinsukwini ezimbili. Ukoma kukhuphuka, ukuphuma komchamo kuyanda, isifiso sokudla siyancipha.
Bese kuba ne-nausea, ukuhlanza, iphunga le-acetone elisuka emlonyeni. Uma kungekho i-insulin, isiguli siwela ekhefini likashukela. Ukunakekelwa okuphuthumayo komzimba onesifo sikashukela neqembu le-ambulensi kuyadingeka.
Ngokukhethwa kahle komthamo, kuyadingeka ukuthi unake ukuthi lapho isimo sesiguli noma izifo ezihlangene zishintsha, kulungiswa ukulashwa. Kuboniswa ezimweni ezinjalo:
- Ukuphazamiseka kwe-gland yegilo.
- Izifo zesibindi noma izinso, ikakhulukazi ubudala.
- Ukutheleleka ngegciwane.
- Ukwanda kokuzivocavoca komzimba.
- Ukushintshela kokunye ukudla.
- Ukuguqulwa kohlobo lwe-insulin, umkhiqizi, ukuguquka kusuka ezilwaneni kuya kumuntu.
Ukusetshenziswa kwe-inulin nezidakamizwa eqenjini le-thiazolidinediones (Aktos, Avandia) kwandisa ingozi yokuhluleka kwenhliziyo. Ngakho-ke, iziguli ezinokulimazeka kokusebenza kwenhliziyo zinconywa ukubheka isisindo somzimba ukuze zithole i-edema ye-latent.
Ukungezwani komzimba kungaba sendawo ngendlela yokuvuvukala, ubomvu, noma ukulunywa kwesikhumba. Imvamisa iba yesikhashana bese idlula yodwa. Izimpawu ezijwayelekile zokungezwani komzimba zibangela lezo zimpawu: ukuqubuka emzimbeni, isicanucanu, i-angioedema, i-tachycardia, ukuphefumula komoya. Lapho zenzeka, kuyenziwa ukwelashwa okukhethekile.
Isimo esiphuthumayo se-Protamine-insulin sifakwe ku-contraindication uma kwenzeka kutholakala ukuthi kukhona i-hypersensitivity ne-hypoglycemia.
I-Insulin Protamine ngesikhathi sokukhulelwa nokuqunjelwa
Njengoba i-insulin inganqamuki ku-placenta, ngesikhathi sokukhulelwa singasetshenziselwa ukunxephezela isifo sikashukela. Lapho uhlela ukukhulelwa, kuboniswa ukuhlolwa okugcwele kwabesifazane abanesifo sikashukela.
I-trimester yokuqala iqhubeka iphikisana nesizinda sokwehla kwesidingo se-insulin, kanti okwesibili nokwesithathu kukhuphuka kancane kancane komuthi olungiselelwe. ngemuva kokubeletha, ukwelashwa kwe-insulin kwenziwa ngemithamo ejwayelekile. Ngesikhathi sokulethwa, ukwehla okubukhali komthamo womuthi olungiselelwe kungenzeka.
I-lactation kanye nokuphathwa kwe-insulin kungahlanganiswa, ngoba i-insulin ayinakungena obisini lwebele. Kepha ushintsho ngemuva kwesizinda se-hormonal yabesifazane ludinga ukulinganiswa okuvame kakhulu kwezinga le-glycemia nokukhethwa kwemithamo efanele.
Ukusebenzisana kwe-insulin neminye imithi
Isenzo se-insulin sithuthukiswa uma sisetshenziswa ndawonye namaphilisi anciphisa ushukela, i-beta-blockers, i-sulfonamides, i-tetracycline, amalungiselelo we-lithium, uvithamini B6.
I-Bromocriptine, ama-anabolic steroid. I-Hypoglycemia ingenzeka ngokuhlanganiswa kwe-insulin ne-ketokenazole, i-clofibrate, i-mebendazole, i-cyclophosphamide, ne-ethyl alcohol.
Iziguli zinentshisekelo embuzweni wokuthi ungayinciphisa kanjani i-insulin egazini. I-Nicotine, i-morphine, i-clonidine, i-danazole, i-tablet contracepiment, i-heparin, i-thiazide diuretics, i-glucocorticosteroids, ama-antidepressants ama-troticclic, ama-hormone we-thyroid, ama-sympathomimetics nabamelene ne-calcium anganciphisa umsebenzi we-insulin.
Ividiyo ekulesi sihloko isitshela ukuthi i-insulin idingeka kanjani nokuthi ungayifaka kanjani.
