I-insulin yi-hormone edlala indima ebalulekile ekuqinisekiseni ukusebenza okujwayelekile komzimba womuntu. Ikhiqizwa ngamaseli e-pancreatic futhi ikhuthaza ukumuncwa kwe-glucose, okuwumthombo oyinhloko wamandla kanye nokudla okuyinhloko kwengqondo.
Kepha kwesinye isikhathi, ngasizathu simbe, ukugcinwa kwe-insulin emzimbeni kuncipha kakhulu noma kuye ngokuphelele, ukuthi ungaba kanjani nokuthi ungasiza kanjani. Lokhu kuholela ekwephuleni kanzima i-carbohydrate metabolism kanye nokukhula kwesifo esiyingozi njengesifo sikashukela.
Ngaphandle kokwelashwa okufika ngesikhathi nangendlela efanele, lesi sifo kungaholela emiphumeleni emibi, kufaka phakathi ukulahleka kombono nezingalo. Ukuphela kwendlela yokuvimbela ukukhula kwezinkinga imijovo ejwayelekile ye-insulin etholwe ngokwenziwe.
Kepha kwenziwa ini i-insulin yabanesifo sikashukela futhi kuwuthinta kanjani umzimba wesiguli? Le mibuzo iyathakazelisa kubantu abaningi abatholakala benesifo sikashukela. Ukuqonda lokhu, udinga ukubheka zonke izindlela zokuthola i-insulin.
Izinhlobo
Amalungiselelo e-insulin anamuhla ahluka ngezindlela ezilandelayo:
- Umthombo wemvelaphi;
- Isikhathi sokusebenza;
- i-pH yesisombululo (acidic noma hlangothi);
- Ukuba khona kwezivikelo (phenol, cresol, phenol-cresol, methylparaben);
- Ukuhlushwa kwe-insulin kungama-40, 80, 100, 200, 500 IU / ml.
Lezi zibonakaliso zithinta ikhwalithi yomuthi, izindleko zawo kanye nezinga lomthelela emzimbeni.
Imithombo
Ngokuya ngomthombo, amalungiselelo e-insulin ahlukaniswe ngamaqembu amabili ayinhloko:
Izilwane. Zitholakala kuma-pancreas ezinkomo nasezingulubeni. Zingaba ezingaphephile, ngoba zivame ukubangela ukusabela okukhulu komzimba. Lokhu kuyiqiniso ikakhulukazi nge-bovine insulin, equkethe ama-amino acid amathathu angenakutholakala kubantu. I-insulin yengulube iphephe njengoba ihluka nge-amino acid eyodwa. Ngakho-ke, isetshenziswa kaningi ekwelapheni isifo sikashukela.
Okomuntu Zingezinhlobo ezimbili: ezifanayo nezomuntu noma ezenziwe ngemvelo, ezitholakala kwi-porcine insulin ngokuguqulwa kwe-enzymatic kanye ne-DNA yomuntu noma ephindaphindwayo, ekhiqiza ama-bacterium we-E. coli sibonga ngokufezeka kobunjiniyela bezakhi zofuzo. Lokhu kulungiswa kwe-insulin kufana ngokuphelele nama-hormone atholwe ngamanyikwe abantu.
Namuhla, i-insulin, eyomuntu neyezilwane, isetshenziswa kabanzi ekwelapheni isifo sikashukela. Ukukhiqizwa kwanamuhla kwe-insulin yezilwane kubandakanya izinga eliphakeme kakhulu lokuhlanzwa kwalo muthi.
Lokhu kusiza ukuqeda ukungcola okungathandeki okunjengama-proinsulin, glucagon, somatostatin, amaprotheni, ama-polypeptides, angadala imiphumela emibi kakhulu.
Umuthi ongcono kakhulu wemvelaphi yezilwane uthathwa njenge-insulin yesimanje, okungukuthi, ekhiqizwa ngokukhishwa kwe "insimbi" ye-insulin.
Isikhathi sesenzo
Ukukhiqizwa kwe-insulin kwenziwa ngokuya ngobuchwepheshe obuhlukile, obuvumela ukuthola izidakamizwa zezikhathi ezahlukahlukene zomsebenzi, ezithi:
- isenzo se-ultrashort;
- isenzo esifushane;
- isenzo eside
- ubude besikhathi sokusebenza;
- ukuthatha isikhathi eside;
- isenzo esihlangene.
I-Ultrashort insulin. Lokhu kulungiswa kwe-insulin kwehluka ngokuthi baqala ukwenza isenzo ngemuva komjovo futhi bafinyelele inani labo eliphakeme ngemuva kwemizuzu engama-60-90. Isikhathi sabo sokwenza sisonke asidluli amahora angama-3-4.
Kunezinhlobo ezimbili eziphambili ze-insulin ezine-ultrashort isenzo - lena yiLizpro ne-Aspart. Ukukhiqizwa kwe-Lizpro insulin kwenziwa ngokuhlela kabusha izinsalela ezimbili ze-amino acid emolekyulu yama-hormone, okuyi-lysine ne-proline.
Ngenxa yalokhu kuguqulwa kwe-molecule, kungenzeka ukugwema ukwakheka kwe-hexamers futhi kusheshiswe ukubola kwayo kube ngama-monomers, okusho ukuthuthukisa ukufakwa kwe-insulin. Lokhu kukuvumela ukuthi uthole amalungiselelo e-insulin angena egazini isiguli kathathu ngokushesha kune-insulin yomuntu yemvelo.
Enye i-insulin esebenza ngokubambelela emfushane yi-Aspart. Izindlela zokukhiqiza i-Aspart insulin ngezindlela eziningi ezifanayo nokukhiqizwa kweLizpro, kuphela kuleli cala, i-proline ithathelwa indawo nge-aspartic acid engenacala.
Kanye neLizpro, i-Aspart isheshe yehle ibe ama-monomers ngakho-ke iconswa egazini cishe ngokushesha. Onke amalungiselelo e-insulin alandelwayo avunyelwe ukuphathwa ngokushesha ngaphambi noma ngokushesha ngemuva kokudla.
Ukuthatha insulin okufushane. Lokhu okufakwayo kuyizixazululo ze-pH ezingathathi hlangothi (6.6 kuya ku-8.0). Banconywa ukuthi baphathwe njenge-insulin ngokungagungqi, kepha uma kunesidingo, imijovo ye-intramuscular noma eyehlayo ivumelekile.
Lamalungiselelo e-insulin aqala ukusebenza kungakapheli nemizuzu engama-20 ngemuva kokungenwa. Umphumela wazo uhlala maduze - awudluli emahoreni ayi-6, futhi ufinyelela isilinganiso sawo ngemuva kwamahora ama-2.
Ukufakwa insulin okufushane okwenzelwe ukwelashwa kweziguli ezinesifo sikashukela esibhedlela. Basiza ngempumelelo iziguli ezinesifo sikashukela nesibindi. Ngaphezu kwalokho, zikuvumela ukuthi unqume ngokunembile imithamo edingekayo ye-insulin esigulini.
Isikhathi sokuphakathi esiphakathi. Le mishanguzo ichitha kabi kakhulu kunama-insulin asebenza ngamafuphi. Ngakho-ke, bangena egazini kancane, okuwukhulisa kakhulu umphumela wabo we-hypoglycemic.
Ukuthola i-insulin yesikhathi esiphakathi kwesenzo kutholakala ngokungenisa ekwakhiweni kwabo i-prolongator ekhethekile - i-zinc noma i-protamine (isophan, protafan, basal).
Ukulungiswa okunjalo kwe-insulin kuyatholakala ngesimo sokumiswa, ngenombolo ethile yamakristalu e-zinc noma i-protamine (imvamisa kakhulu i-protamine Hagedorn ne-isophane). Ama-prolonger akhulisa kakhulu isikhathi sokufakwa komuthi ezingxenyeni ezingaphansi komhlaba, esandisa kakhulu isikhathi sokungena kwe-insulin egazini.
Ukuthatha isikhathi eside ukufaka insulin. Lona yi-insulin yesimanje kakhulu, ukukhiqizwa kwayo kwenziwa ngenxa yokubonga kobuchwepheshe be-DNA recombinant. Ukulungiselela kokuqala kwe-insulin okwenzeka isikhathi eside kwakuyi-Glargin, okuyi-analogue ngqo ye-hormone ekhiqizwa ama-pancreas womuntu.
Ukuyithola, ukuguqulwa okuyinkimbinkimbi kwe-molecule ye-insulin kuyenziwa, okubandakanya ukushintshwa kwe-asparagine nge-glycine kanye nokungezelelwa okwalandela kwezinsalela ezimbili ze-arginine.
I-Glargine itholakala ngesisombululo esikhanyayo nge-pic ene-acidic ye-pic ka-4. Le pH ivumela i-insulin hexamers ukuthi ibe ezinzile ngokwengeziwe futhi ngaleyo ndlela iqinisekise ukufakwa umuthi okude nokubikezelayo egazini lesiguli. Kodwa-ke, ngenxa ye-pH ene-acidic, i-Glargin ayituswa ukuba ihlanganiswe nama-insulin amafushane, ajwayele ukuba ne-pH engathathi hlangothi.
Iningi lamalungiselelo we-insulin ane-okuthiwa "inani eliphakeme kakhulu lesenzo", lapho kufinyelelwa khona ukuthi i-insulin ephezulu kakhulu ibonwa egazini lesiguli. Kodwa-ke, isici esiyinhloko se-Glargin ukuthi ayinayo iphezulu lesenzo.
Umjovo owodwa nje womuthi owanele ngosuku ukunikeza isiguli amandla athembekile angenakubekezela wokulawula i-glycemic emahoreni angama-24 alandelayo. Lokhu kutholakala ngenxa yokuthi i-Glargin idonswa kusuka kwezicubu ezingaphansi ngesilinganiso esifanayo kuyo yonke inkathi yesenzo.
Amalungiselelo we-insulin asebenza isikhathi eside akhiqizwa ngezindlela ezahlukahlukene futhi anganikeza isiguli umphumela we-hypoglycemic amahora angama-36 ngokulandelana. Lokhu kusiza ukunciphisa kakhulu inani lemijovo ye-insulin ngosuku futhi ngaleyo ndlela yenze lula impilo yeziguli ezinesifo sikashukela.
Kubalulekile ukuqaphela ukuthi i-Glargin iyanconywa ukuthi isetshenziselwe kuphela ukulimala kokuthamba kanye ne-intramuscular. Lesi sidakamizwa asifanele ukwelashwa kwezimo ze-comatose noma zokuthandeka ezigulini ezinesifo sikashukela i-mellitus.
Izidakamizwa ezihlanganisiwe. Le mishanguzo iyatholakala ngefomu lokumiswa, eliqukethe isisombululo se-insulin engathathi hlangothi ngesenzo esifushane kanye nama-insulin asebenza phakathi nendawo nge-isofan.
Izidakamizwa ezinjalo zivumela isiguli ukuthi sifake i-insulin yezikhathi ezahlukahlukene emzimbeni wayo ngomjovo owodwa nje, okusho ukugwema imijovo eyengeziwe.
Izinto zokubulala amagciwane
Ukubulawa kwamagciwane ngamalungiselelo e-insulin kubaluleke kakhulu ekuphepheni kweziguli, ngoba zifakwa emzimbeni wakhe futhi zithwalwa kuwo wonke amalungu angaphakathi nezicubu ngokugeleza kwegazi.
Umphumela othile we-bactericidal unezinto ezithile ezingeziwe ekwakhiweni kwe-insulin hhayi njenge-disinfectant, kodwa futhi njengezivimbelakuvunda. Lokhu kufaka phakathi i-cresol, phenol ne-methyl parabenzoate. Ngaphezu kwalokho, umphumela obizwa ngokuthi yi-antimicrobial futhi ubonakala ngama-zinc ion, okuyingxenye yezinye izixazululo ze-insulin.
Ukuvikelwa kwe-multilevel ekuthelelekeni kwegciwane, okutholakala ngokungeza izithasiselo kanye namanye ama-antiseptic agents, kungavimba ukuthuthukiswa kwezinkinga eziningi ezinzima. Ngemuva kwakho konke, ukujova okuphindayo kwenaliti yesirinji emgqonyeni we-insulin kungadala ukutheleleka komuthi ngamagciwane we-pathogenic.
Kodwa-ke, izakhiwo ze-bactericidal zesisombululo zisiza ukuqeda ama-microorganisms ayingozi futhi zigcine ukuphepha kwaso esigulini. Ngenxa yalesi sizathu, iziguli ezinesifo sikashukela zingasebenzisa isirinji efanayo ukwenza imijovo engaphansi kwe-insulin kuze kube izikhathi eziyi-7 zilandelana.
Enye inzuzo yokuba khona kwezivikelo ekwakhekeni kwe-insulin ukuntuleka kwesidingo sokusebenzisa isibulala magciwane esikhunjeni ngaphambi komjovo. Kepha lokhu kungenzeka kuphela ngama-syncinge akhethekile we-insulin afakelwe inaliti elincanyana kakhulu.
Kumele kugcizelelwe ukuthi ukuba khona kwezivikelo ku-insulin akuzithinti kabi izakhiwo zesidakamizwa futhi kuphephile ngokuphelele esigulini.
Isiphetho
Kuze kube manje, i-insulin, etholwe kusetshenziswa womabili ama-pancreas ezilwane kanye nezindlela zanamuhla zobunjiniyela bezofuzo, isetshenziswa kabanzi ukudala inani elikhulu lezidakamizwa.
Okunconyelwa kakhulu ukwelashwa kwe-insulin kwansuku zonke kuhlanzwe kakhulu ama-insulin asebenza nge-DNA, aboniswa yi-antigenicity ephansi kakhulu, futhi ngenxa yalokho empeleni awubangeli ukungezwani komzimba. Ngaphezu kwalokho, izidakamizwa ezisuselwa kuma-analogues we-insulin yabantu zinekhwalithi ephezulu nokuphepha.
Amalungiselelo we-insulin ayathengiswa emabhodleleni engilazi anamandla ahlukahlukene, abekwa uphawu ngokuvalwa ngamabhulokhi enjoloba futhi afakwe i-aluminium run-in. Ngaphezu kwalokho, zingathengwa emalungeni akhethekile we-insulin, kanye namapeni wesirinji, afaneleka ikakhulukazi ezinganeni.
Izindlela ezintsha eziyisisekelo zokulungiselela i-insulin ziyakhiwa, ezizongeniswa emzimbeni ngendlela ye-intranasal, okungukuthi, ngokusebenzisa i-mucosa yamakhala.
Kwatholakala ukuthi ngokuhlanganisa i-insulin nesikhunta, kungenzeka ukuthi kulungiswe ukulungiswa kwe-aerosol okungafinyelela ukugxilwa okudingekayo egazini lesiguli ngokushesha nje ngomjovo we-intravenous. Ngaphezu kwalokho, amalungiselelo akamuva e-insulin omlomo ayenziwa angathathwa ngomlomo.
Kuze kube manje, lezi zinhlobo ze-insulin zisengaphansi kokukhula noma zivivinywa emitholampilo ezidingekayo. Kodwa-ke, kuyacaca ukuthi esikhathini esizayo esiseduze kuzoba namalungiselelo e-insulin angeke adinge ukujova nesirinji.
Imikhiqizo ye-insulin yakamuva izotholakala ngesimo sokufafaza, okuzovele kudingeke ukuthi kufafazwe engxenyeni ye-mucous yakhala noma yomlomo ukuze kwaneliswe ngokugcwele isidingo somzimba se-insulin.
