Ukuxilonga isifo sikashukela ezigabeni zokuqala zesifo, ngisho nangaphambi kokuqala kwezimpawu, kusetshenziswa indlela yokuxilonga elabhorethri enquma izinga le-hemoglobin ye-glycated.
Amaphesenti we-glycated to whole hemoglobin shows the changes of changes in glucose glucose ezinyangeni ezintathu ezedlule.
Ku-mellitus yesifo sikashukela, kunconywa ukwenza isifundo esinjalo okungenani amahlandla amane ngonyaka ukuze kuhlolwe ukunemba kwemithamo ekhethiwe yezidakamizwa ukwehlisa ushukela.
Ngubani okhonjiswayo incazelo ye-glycated hemoglobin
I-Glycated hemoglobin (HbA1C) ivela lapho ushukela unamathiselwe emolekyulu ye-hemoglobin. Lokhu kusebenzisana kuhamba kancane kepha akunakuphikwa. Ijubane layo ngqo lincike ekutheni lingakanani ushukela oluse-serum yegazi.
Isikhathi sokuphila kwe-hemoglobin enjalo cishe sinezinyanga ezintathu. Ngakho-ke, uma ngaphezulu kwezinsuku ezingama-120 ezedlule kube nokwanda kushukela wegazi, khona-ke ukuzimisela kwe-hemoglobin ye-glycated kuzokhombisa lokhu.
Ukuhlolwa kwegazi kwe-HvA1C kwenziwa ezimeni ezinjalo:
- Ukuxilongwa kwesifo sikashukela i-mellitus, kufaka phakathi isigaba sokutholwa kwamaqembu asengozini.
- Ekwelashweni kohlobo 1 no-Type 2 sikashukela mellitus ukunquma isinxephezelo sikashukela.
- Ukuhlola ubungozi bezinkinga zesifo sikashukela.
- Ukuhlolwa kwabesifazane ngesikhathi sokukhulelwa.
- Iqembu eliyingozi lesifo esinjengalesi sifo sikashukela lifaka izingane nentsha enabazali abanesifo sikashukela abake baba nezifo ezibangelwa amagciwane - i-rubella, mumps, ukutheleleka nge-cytomegalovirus, inkukhu.
Ucwaningo lwe-glycated hemoglobin luboniswa emaqenjini anobungozi enjalo wokuthuthukisa isifo sikashukela sohlobo 2:
- Iminyaka ukusuka eminyakeni engama-40.
- Isisindo somzimba esithe xaxa.
- Ukube umndeni ubenesifo sikashukela.
- Uma kutholakala isilinganiso esengeziwe sikashukela egazini.
- Uma i-carbohydrate metabolism ibilimele ngesikhathi sokukhulelwa, ingane yazalwa inesisindo esingama-4.5 kg noma ngaphezulu.
- Ngomfutho wegazi ophikelelayo oqhubekayo.
- Lapho uthola ukuphazamiseka kwe-metabolism yamafutha - i-cholesterol ephezulu egazini.
- Ngokuguquguquka kwesisindo ngokuzumayo.
- Lapho uthatha izidakamizwa ze-hormonal.
- Ngezifo ze-adrenal gland noma i-pituitary gland.
- Ukuthuthukiswa kokuqala kwe-atherosclerosis (emadodeni ngaphambi kweminyaka engu-40, kwabesifazane - 50).
- Ukuthuthukiswa kwe-Cataract (ukusizakala kwelensi)
- Nge-eczema, i-neurodermatitis, i-dermatitis ye-allergic.
- Ngemuva kwe-pancreatitis eyingozi, ngenkambo ende yesikhathi sokuvuvukala okungapheli kumanyikwe.
Ngaphezu kwalokho, kuzo zonke izimo zokusolwa kwe-mellitus yesifo sikashukela, odokotela ababekeli kokuxilongwa ukuze batadishe i-glycated hemoglobin ukukhipha ukuxilongwa. Uma isiguli sinezimpawu ezinjalo:
- Khulisa ukoma.
- Ukuchama okuningi, ikakhulukazi ebusuku.
- Isikhumba esomile.
- Ukuncipha kwezinwele nokuncipha.
- Isikhumba esi-Itchy nemivimbo ehlukahlukene.
- Ubunzima bokuphola amanxeba.
- Isisindo se-acuity ebonakalayo.
- Ukugabha, ukudonsa kwezitho ezahlukahlukene zomzimba, ikakhulukazi iminwe.
- Ukuphuphuma kwesisu.
- Imvamisa yokutheleleka njalo kwezifo ezithathelanayo noma zokukhunta (i-thrush, mycoplasmosis, gardnerellosis).
- Ekwelashweni kwesifo sikashukela, kunconywa ukuthi kubhekwe ngezikhathi ezithile zezinga le-hemoglobin ye-glycated ukuhlola ukunemba kwendlela enqunyelwe. Lokhu akukhanseli ukuhlolwa kwegazi kwe-glucose, kepha kukuvumela ukuthi ukhombe amaconsi angalawulwa isikhathi eside.
Ngokuya ngokuthi ungayilonda kangakanani impilo enhle nezinga le-glucose enconyiwe, imvamisa yalolu cwaningo iyanqunywa. Ngokwesilinganiso, kunconywa izikhathi ezi-2 kuye kwezi-4 ngonyaka.
Ekunqumeni amanani we-НвА1С ezindaweni zokusebenzela, kusetshenziswa izindlela ezihlukene zokuhlaziya; ngakho-ke, kunconyelwa ukubuka amandla ale nkomba elabhorethri efanayo.
Ingozi yokuba nesifo sikashukela incike ngqo kuzinga le-glucose. Ngakho-ke, ukwehla kwe-hemoglobin ye-glycated noma nge-1% kunciphisa ubungozi bokukhula. I-Nephropathy (ukulimala kwezinso ngokuthuthukiswa kokungasebenzi kahle) ngo-44%.
I-retinopathies (izinguquko ku-retina, okuholela ebumpumputhe) ngama-35%. Ukufa kusuka ezinkingeni zesifo sikashukela ngama-25%.
Ngasikhathi sinye, ama-endocrinologists, ikakhulukazi asebekhulile, akafuni ukufinyelela izinga elifanele, ngoba lokhu kuholela engcupheni yokwehla kwe-glucose egazini, ngisho nasenkingeni efana ne-glycemic coma. Ngakho-ke, kubantu asebekhulile, okujwayelekile kuphezulu ngo-10% kunenani eliphakeme.
Ebusheni abasebenzayo, i-hemoglobin ye-glycated kufanele igcinwe ngaphakathi kwamanani abo ajwayelekile, lokhu kuqinisekisa ukusebenza okuhle nokuvimbela ukukhula kwezinkinga zesifo sikashukela.
Ngesikhathi sokukhulelwa, ukuguquguquka kwesizinda se-hormonal kanye nokuzwela kwezicubu ku-insulin kungahle kwehle ngenxa yesenzo samahomoni akhiqizwa yi-placenta.
I-glucose ejwayelekile yegazi kubantu besifazane abakhulelwe akufanele idlule ku-5.1 mmol / L. Uma lelizinga liphezulu, kepha lingangeqi ku-7.8 mmol / L, abesifazane batholakala benesifo sikashukela sokukhulelwa. Lolu hlobo lwesifo sikashukela lungahambisana nokukhulelwa, kepha ngemuva kokuzalwa, i-carbohydrate metabolism ibuyela kokujwayelekile.
Ngakho-ke, ukufunda ubungozi bokuthola i-mellitus yesifo sikashukela, abesifazane abakhulelwe baboniswa ukuhlaziywa kwe-hemoglobin ye-glycated kanye nokuhlolwa kokubekezelela kwe-glucose emavikini ama-22-24 wokukhulelwa.
Ngaphezu kwalokho, izinga le-HBA1C empeleni lilawulwa kwabesifazane abakhulelwe abanesifo sohlobo lwe-2 mellitus, ikakhulukazi labo abanomsebenzi wezinso ongasebenzi kahle, onomfutho wegazi ophakeme, noma uma kutholakala amazinga aphezulu e-cholesterol.
Ukunqunywa kwe-hemoglobin ye-glycated kwabesifazane kanye nokuhlolwa kwemiphumela
Ukunquma izinga le-hemoglobin ye-glycated kunezinzuzo kunezinye izindlela zokucwaninga:
- Kungenziwa nganoma yisiphi isikhathi sosuku.
- Akukho kulungiselela kwangaphambili okudingekayo.
- Umphumela wokuhlaziywa awuthinteki ezimweni ezicindezelayo, umkhuhlane, ezemidlalo, umsoco, ukuphuza utshwala.
- Inkomba ithembekile futhi isusa ukuhlanekezela ngenhloso.
- Umjikelezo wokuya esikhathini kwabesifazane, isigaba sabo asisho lutho ngesikhathi sokufunda.
- Isikhombi sikhombisa ukuguquguquka kwamazinga kashukela isikhathi eside, kunokunyuka kwesimo.
- Ivumela ukwelashwa kwe-prophylactic ngengozi yokuba nesifo sikashukela noma izinkinga zayo.
Imiphumela yokuhlaziya ayihlukile ngobudala noma ubulili. Isimo se-hemoglobin ye-glycated kwabesifazane nakwabesilisa sithathwa njengesinkomba sisuka ku-4,5% siye ku-6.5%. Lapho inkomba isuka kumaphesenti angama-5.5 kuya kwayi-7, kutholakala isifo sikashukela, lokhu kuwuphawu olunokwethenjelwa lokuncipha kokubekezelela i-glucose.
Isinxephezelo sikashukela wegazi kwabesifazane abathatha ukwelashwa ngemithi ye-hypoglycemic sihlolwe izinkomba ezilandelayo ze-HBa1C:
- I-7-8% - isinxephezelo esihle;
- 8-10% - isinxephezelo esanele;
- I-10-12% - isinxephezelo esiyinxenye;
- ngaphezu kwe-12% - isifo sikashukela sinenkambo engabhalisiwe.
Ngaphezu kwesifo sikashukela i-mellitus, ukukhuphuka kwe-hemoglobin ene-glycated kuthinteka ngenxa yokushoda kwensimbi, ukukhipha i-spleen, kanye nomphumela ongemuhle wokungabi nalutho nge-fetus hemoglobin. I-fetal hemoglobin ingavela egazini labesifazane ngesikhathi sokukhulelwa, izifo zegazi, ngokuntuleka komoya-mpilo ezicutshini.
Futhi, inkomba ye-HvA1C ingakhuphuka lapho kuthathwa imithamo emikhulu ye-acetylsalicylic acid, ukuntuleka kwevithamini B 12, nokusetshenziswa okungapheli kwezidakamizwa ze-opium, uphuzo oludakayo, kanye nokwehluleka kwezinso.
Ngesikhathi sokukhulelwa, amazinga eglucose egazini angakhuphuka, lokhu kudinga ukuxilongwa okwengeziwe. Isimo esijwayelekile kwabesifazane be-hemoglobin ye-glycated ngalesi sikhathi senziwe ngokweqile futhi ucwaningo alunamibandela kuze kube izinyanga eziyi-8 zokukhulelwa.
Ezigabeni zakamuva, ukujwayela okweqile koshukela oku-glycated egazini kukhombisa ukusongela kokuzalwa kwengane enkulu enesisindo esingaphezu kwama-4,5 kg kanye nokwephulwa kwe-carbohydrate metabolism enganeni engakazalwa.
I-hemoglobin ye-Glycated ingancipha ngaphansi kwale mibandela elandelayo:
- Ukunciphisa ushukela wegazi nge-overdose ye-insulin noma amaphilisi ukwehlisa ushukela.
- Ukudla okuhlala isikhathi eside kwe-carb noma ukuzila.
- Ukuzivocavoca okukhulu komzimba.
- Ngezifo ezibangelwa yifa - uHerce, uForbes, ukungabekezeleli ifa le-fructose.
- Ukubhujiswa kwamangqamuzana abomvu egazi ane-hemolytic anemia.
- Ukulahleka kwegazi okukhulu, ukuhlinzwa okuningana.
- Uma kube nokuchitheka kwegazi ezinyangeni ezintathu ezedlule.
- Lapho uthatha i-erythropoietin, amalungiselelo e-iron, uvithamini B 12, ascorbic acid no-Vitamin E.
- Kwezifo zesibindi ezingamahlalakhona - i-hepatitis, i-hepatosis enamafutha.
- Lapho wenza ukwelashwa kwama-antiviral nge-ribavirin.
- Uma igazi liqukethe i-triglycerides ephakeme (ukungasebenzi kahle kwama-metabolism).
- Ngesikhathi sokukhulelwa.
Ngazo zonke izici ezinhle zale ndlela yokuhlola, ibuye ibe nezingqinamba. Lokhu kungafaka izindleko eziphakeme kakhulu zokuhlolwa nokungafinyeleleki kubahlali bezindawo ezincane.
Ezigulini ezinesifo sikashukela kanye namaqembu asengozini ngokukhula kwawo, ukuzimisela kwe-hemoglobin ye-glycated kuvumela ukwelashwa okufanele futhi kuvimbele ukukhula kwezinkinga ezinzima zesifo. Lokhu, ngokudla okune-carb ephansi kanye nokusetshenziswa kwezidakamizwa ezinconyiwe, kungathuthukisa ikhwalithi yempilo.
