Ushukela wegazi uyinkomba ebalulekile. Uma lenyuswa noma yehliswa, khona-ke lesi simo singakhombisa izifo eziningana. Ngakho-ke, nge-glucose enkulu, isifo sikashukela siyakhula, esidinga ukwelashwa okungapheli kanye nendlela ethile yokuphila.
Lesi sifo singenzeka ngesimo esisekude isikhathi eside. Ingozi yezifundo zakamuva ukuthi ngalesi sikhathi izinkinga eziningi zingaba khona (i-retinopathy, i-neuropathy, isifo sikashukela sonyawo, njll.).
Ngakho-ke, kubalulekile ukuhlola umzimba njalo nokwenza ucwaningo lwamanzi omzimba. Kodwa-ke, ingabe ukugxila kwe-glucose kunqunywa ekuhlolweni kwegazi okujwayelekile?
Ngabe isifo sikashukela singatholakala ngokuhlolwa kwegazi okujwayelekile nangokuphilayo?
Ukuhlaziywa kwenziwa esiswini esingenalutho. Okokuqala, amasampula egazi enziwa ukuthola izinga le-hemoglobin kanye ne-erythrocyte sedimentation rate - khona-ke ukuthola inani lamangqamuzana abomvu egazi namaseli amhlophe egazi. Kuze kube manje, ama-smears egazi ayenziwa ezingilazini, ezihlolwe ngaphansi kwesibonakhulu.
Inhloso yalolu cwaningo ukuthola isimo somzimba ejwayelekile. Futhi, ngosizo lwayo, ungakhomba izifo zegazi futhi uthole ukuthi kukhona kwenqubo yokuvuvukala.
Ingabe ukuhlolwa kwegazi okujwayelekile kukhombisa ushukela wegazi? Akunakwenzeka ukunquma ukugxila kwe-glucose ngemuva kocwaningo olunjalo. Kodwa-ke, lapho kuqondiswa izinkomba ezifana ne-RBC noma i-hematocrit, udokotela angasola i-mellitus yesifo sikashukela ngokunciphisa okuqukethwe ushukela.
Izinkomba ezinjalo zibonisa isilinganiso se-plasma kumaseli abomvu egazi. Ukujwayelekile kwabo kusuka ku-2 kuye ku-60%. Uma izinga likhuphuka, khona-ke kukhona amathuba amakhulu we-hyperglycemia engapheli.
Ukuhlaziywa kwe-biochemical kungakhombisa inani loshukela? Le ndlela yokuxilonga ikuvumela ukuthi ufunde cishe ngakho konke ukwephula umthetho ku:
- izitho zomzimba - ama-pancreas, izinso, isibindi, isimangalo senyongo;
- izinqubo ze-metabolic - ukushintshwa kwama-carbohydrate, amaprotheni, ama-lipids;
- ibhalansi yezinto ezilandelwayo namavithamini.
Ngakho-ke, i-biochemistry ingabona ushukela wegazi. Ngakho-ke, lokhu kuhlaziywa kungenye yesibopho sesifo sikashukela, ngoba ngayo ungakhetha indlela efanele yokwelapha futhi uhlole ukusebenza kwayo.
Kepha uma umuntu engazi ngobukhona besifo sikashukela, kepha enesifiso sokuthola ukukhula kwakhe noma izimpawu ezithile zesifo, khona-ke unqunywa ukuthi kuhlolwe ushukela okhethekile.
Kwenziwa nini ukuhlolwa kweshukela egazini?
Uma ukuhlolwa kwegazi kwenziwa, ushukela kuyinkomba enquma hhayi kuphela isifo sikashukela, kodwa futhi nezinye izindlela ze-endocrine, kufaka phakathi isimo se-prediabetesic.
Ukuxilongwa okunjalo kungenziwa ngokwesicelo sakhe isiguli uqobo, kepha imvamisa isisekelo sokuqaliswa kwayo yisiqondiso se-endocrinologist noma i-Therapist.
Njengomthetho, izinkomba zokuhlolwa kwegazi yilezi:
- ukunciphisa isisindo;
- ukwanda kwesifiso sokudla;
- ukoma nomlomo owomile;
- ukukhathala kanye nokubabaza;
- ukuchama njalo
- iminyakazo
- ukungaphatheki kahle.
Ukutadisha kwegazi kungafakwa kusethi yokuhlolwa okuyimpoqo, enikezwe hhayi kuphela isifo sikashukela, kodwa futhi uma kwenzeka kuba nomfutho wegazi ophakeme kanye nokukhuluphala. Futhi, igazi likashukela kufanele lithathwe ngezikhathi ezithile kulabo bantu abanezihlobo zabo ezazinezinkinga ngezinqubo ze-metabolic.
Noma kunjalo, ucwaningo olunjalo ngeke lube luhle enganeni, ikakhulukazi uma enezimpawu ezingenhla. Unganquma izinga likashukela ekhaya usebenzisa i-glucometer noma usesho lokuhlola. Kodwa-ke, zingahle zinganembile ngo-20%, ngokungafani nokuhlolwa kwelebhu.
Kepha kubalulekile ukukhumbula ukuthi ezinye izinhlobo zokuhlaziywa okuqondiswe kuzo zibhekiswe ku:
- ukuqinisekisile isifo sikashukela;
- ngesikhathi sokukhulelwa;
- izifo ezingalapheki ezisezingeni lokuthi ziyanda.
Izinhlobo zokuhlaziya
Ukuthola isifo sikashukela nezinye izinkinga ngohlelo lwe-endocrine kudinga ukuhlolwa ngezinyathelo eziningi. Okokuqala, kunikezwa ukuhlolwa kwegazi okujwayelekile koshukela. Ngemuva kwalokho i-endocrinologist ingabeka izifundo ezengeziwe ukukhomba izimbangela zokushintshashintsha kwamanani eglucose.
Kunezinhlobo eziningi zokuhlolwa ezinquma ukunqwabelana kwe-glucose. Okuvame kakhulu ukuhlolwa koshukela okulula.
I-Biomaterial ithathwa emunweni noma emvinini. Ngasikhathi sinye, isilinganiso se-glucose esegazini le-venous siphezulu ngo-12%, okucatshangelwa ukuthi lapho kukhishwa. Kumuntu ophilile, izinkomba ze-glucose kufanele zibe ngale ndlela elandelayo:
- iminyaka efinyelela kwenyanga engu-1 - 2.8-4.4 mmol / l;
- kuze kube seminyakeni engu-14 ubudala - 3.3-5.5. mmol / l;
- ngaphezulu kweminyaka engu-14 - 3.5-5.5 mmol / l.
Uma ukugcwala koshukela egazini okuthathwe emthanjeni kungaphezu kuka-7 mmol / l, no-6.1 mmol / l kusuka emunweni, khona-ke lokhu kubonisa ukwephulwa kokubekezelela ushukela noma isimo sangaphambi kwesifo sikashukela. Uma izinkomba ziphakeme kakhulu, khona-ke kutholakala isifo sikashukela.
Kwezinye izimo, ukunqunywa kwezinga le-fructosamine kuyenziwa - ukuxhumana kwe-glucose ene-albhamuin noma amanye amaprotheni. Umcimbi onjalo uyadingeka ukuqinisekisa ubukhona besifo sikashukela noma ukuqapha ukusebenza ngempumelelo kokwelashwa okukhona.
Kuyaqapheleka ukuthi lokhu kuhlaziya kuyindlela kuphela yokunquma izinga loshukela ngokulahleka okukhulu kwesisindo segazi elibomvu (i-anemia ku-mellitus yesifo sikashukela, ukulahleka kwegazi). Kepha ayisebenzi nge-hypoproteinemia ne-proteinuria enzima.
Ukugxila okujwayelekile kwe-fructosamine kufinyelela ku-320 μmol / L. Esikhathini sikashukela esinxephekile, izinkomba zisukela ku-286 kuye ku-320 μmol / L, futhi esimeni esinqunyelwe, zingaphezulu kuka-370 μmol / L.
Ukufunda izinga le-hemoglobin ye-glycated kunquma iphesenti lalezi zinto ezimbili. Le ndlela yokuxilonga ikuvumela ukuthi ubheke ukusebenza ngempumelelo kwezindlela zokuthola isifo sikashukela futhi unqume izinga lesinxephezelo salo. Kodwa-ke, ezinganeni ezingaphansi kwezinyanga eziyisithupha nabesifazane abakhulelwe, le nqubo icasulwe.
Imiphumela yokuhlolwa ihlotshwe ngale ndlela elandelayo:
- okujwayelekile kungu-6%;
- I-6.5% - ushukela osolwayo;
- ngaphezu kwe-6.5% - ingozi enkulu yokuba nesifo sikashukela, kubandakanya nemiphumela yako.
Kodwa-ke, ukuqina okunyukayo kungenzeka nge-iron defence anemia kanye ne-splenectomy. Okuqukethwe okuphansi kutholakala esimweni sokumpompela igazi, ukopha kanye ne-hemolytic anemia.
Ukuhlolwa kokubekezelela kwe-glucose kungenye indlela yokuthola ukunakekelwa koshukela. Kwenziwa ngesisu esingenalutho, imizuzu engama-120 ngemuva kokuzivocavoca. Ngakho-ke, ungathola ukuthi umzimba uphendula kanjani ekuphuzeni i-glucose.
Okokuqala, umsizi weelebhu ulinganisa izinkomba esiswini esingenalutho, bese kuba ihora eli-1 kanye namahora ama-2 ngemuva kokulayisha ushukela. Kulokhu, inkomba ejwayelekile yoshukela iyakhuphuka, bese ihle. Kodwa ngesifo sikashukela, ngemuva kokuthatha isixazululo esimnandi, izinga alinciphile ngisho nangemva kwesikhashana.
Lokhu kuvivinywa kokukhuthazela kwe-glucose kunezindlela eziningi zokuphikisana:
- iminyaka efinyelela eminyakeni eyi-14;
- glucose osheshayo mkhulu kuno-11.1 mmol / l;
- infarction myocardial;
- ukuzalwa noma ukuhlinzwa kwakamuva
Izinkomba ze-7.8 mmol / L zibhekwa njengejwayelekile, uma ziphezulu, khona-ke lokhu kubonisa ukwephulwa kokubekezelelana kwe-glucose kanye ne-prediabetes. Lapho okuqukethwe ushukela kungaphezu kuka-11.1 mmol / L, lokhu kukhombisa isifo sikashukela.
Ukuhlaziywa okuthile okulandelayo ukuhlolwa kokubekezelela i-glucose ngokutholwa kwe-C-peptide (i-proinsulin molecule). Ukuhlaziywa kuhlola ukuthi ama-beta-cell akhiqiza kanjani umsebenzi we-insulin, osiza ekuboneni uhlobo lwesifo sikashukela. Ucwaningo lwenziwa futhi ukulungisa ukwelashwa kwalesi sifo.
Imiphumela yokuhlolwa imi ngalendlela elandelayo: amanani amukelekayo ngu-1.1-5.o ng / ml. Uma zikhulu, khona-ke kukhona amathuba aphezulu okuba khona kwesifo sikashukela sohlobo 2, i-insulinoma, ukwehluleka kwezinso, noma i-polycystic. Ukuhlushwa okuphansi kubonisa ukuntuleka kokukhiqizwa kwe-pancreatic insulin.
Ukutholwa kokuqukethwe kwe-lactic acid esegazini kukhombisa izinga lokugcwala kwamakhemikhali. Ukuhlolwa kukuvumela ukuthi ukhombe isifo sikashukela, i-hypoxia, izifo zegazi kushukela kanye nokwehluleka kwenhliziyo.
Amanani ajwayelekile wokuhlaziywa yi-0.5 - 2.2 mmol / L. Ukwehla kwezinga likhombisa i-anemia, futhi ukwanda kubonwa nge-cirrhosis, ukuhluleka kwenhliziyo, i-pyelonephritis, i-leukemia nezinye izifo.
Ngesikhathi sokukhulelwa, ushukela unqunywa ngokuhlolwa kokukhuthazela kwe-glucose ukuthola ukuthi isiguli sinesifo sikashukela sokukhulelwa. Ukuhlolwa kwenziwa emavikini angama-24- 28. Igazi lithathwa esiswini esingenalutho, ngemuva kwemizuzu engama-60. nokusebenzisa ushukela kanye namahora ama-2 alandelayo.
Kuhle ukukhumbula ukuthi cishe zonke izivivinyo (ngaphandle kokuhlolwa kwe-glycated hemoglobin) zinikezwa esiswini esingenalutho. Ngaphezu kwalokho, udinga ukubulawa yindlala okungenani amahora angama-8 futhi kungabi ngaphezu kwamahora ayi-14, kepha ungakwazi ukuphuza amanzi.
Futhi, ngaphambi kocwaningo, kufanele ulahle utshwala, ama-carbohydrate namaswidi. Ukuzivocavoca, ukucindezela kanye nezifo ezithathelwanayo kungathinta nemiphumela yokuhlolwa. Ngakho-ke, kufanele usiqaphe ngokucophelela isimo ngaphambi kokuhlolwa, okuzokwenza imiphumela inembe ngangokunokwenzeka. Ividiyo ekulesi sihloko izokwengeza ngokukhuluma ngomsuka wokuhlolwa kweglucose yegazi.
