Ucwaningo lwe-insulin olungasebenzi kahle lwenza ukuthi sikwazi ukuqonda ikhwalithi yokukhiqizwa kwe-insocrine insulin kulezo ziguli ezingazange zithole amalungiselelo e-insulin futhi zingakwenzanga lokhu ngaphambili, ngoba ama-antibodies azoqala ukukhiqizwa into exo native emzimbeni wesiguli, angahlanekezela umphumela wokuhlola weqiniso.
Okuqukethwe kwe-IRI esegazini lokuzila komuntu kuzobhekwa njengokujwayelekile uma kusuka ku-6 kuye ku-24 mIU / L (le nkomba izohluka ngokuya ngohlelo lokuhlola olusetshenzisiwe). Isilinganiso se-insulin ushukela ezingeni elingaphansi kwama-40 mg / dl (i-insulin ilinganiswa ku-mkED / ml, noshukela ku-mg / dl) ngaphansi kuka-0.25. Ezingeni likashukela elingaphansi kuka-2.22 mmol / L, ngaphansi kuka-4.5 (insulin ikhonjiswa ku-mIU / L, ushukela ku-mol / L).
Ukuzimisela kwehomoni kuyadingeka ekwakhiweni okuyikho kwesifo sikashukela kulezo ziguli okuboniswa kuzo izinkomba zokuhlola ukubekezelela i-glucose. Ngo-mellitus wesifo sikashukela sohlobo lokuqala, i-insulin izokwehliswa, bese ngohlobo lwesibili izoba kumaki ojwayelekile noma ikhuphuke. Izinga eliphakeme le-insulin elisebenzayo lizoqapheleka ngalezo zifo ezinjengalezi:
- i-acomegaly;
- I-Itsenko-Cushing's syndrome;
- insulinoma.
Imvelo ngokweqile
Ukuphindaphindeka okubili kokujwayelekile kuzophawulwa ngamazinga ahlukahlukene wokukhuluphala. Uma isilinganiso se-insulin ushukela wegazi singaphansi kuka-0,25, kuzoba nemfuneko yokusola i-insulinoma.
Ukusungula izinga lokujikeleza kwe-insulin kuyinkomba ebalulekile yokufunda i-pathophysiology yamafutha kanye ne-carbohydrate metabolism. Ngokombono wokubuka kwenkambo yesifo, amazinga we-insulin angadlala indima enkulu ekutholakaleni kwe-hypoglycemia. Lokhu kubaluleke kakhulu uma i-hypoglycemia ikhula ngesikhathi sokukhulelwa.
Okuqukethwe kwe-insulin okutholakele kuzinze kakhulu kuyi-plasma yegazi lomuntu kune-serum yayo. Lokhu kungachazwa kusetshenziswa ama-anticoagulants. Kungenxa yalesi sizathu ukuthi ukuzimisela kwe-insulin engasebenzi emzimbeni okokuqala kuyathandeka kakhulu ekwenzeni ukuxilongwa okulungile. Le nqubo ingahlanganiswa nokuhlolwa kokubekezelela ushukela.
Ukusabela okujwayelekile
| Isikhathi ngemuva kokuzivocavoca ushukela (imizuzu) | I-Insulin μU / ml (mIU / L) |
| 0 | 6 - 24 |
| 30 | 25 - 231 |
| 60 | 18 - 276 |
| 120 | 16 - 166 |
| 180 | 4 - 18 |
Ngohlobo 1 sikashukela, impendulo yokusebenzisa ushukela kuzoba ngu-zero, futhi ngohlobo 2 lwesifo sikashukela esinenkinga yokukhuluphala, impendulo izokwehliswa. Izinga le-insulin emzimbeni ngemuva kwamahora ama-2 lingakhuphukela kumanani aphakeme kakhulu futhi lingafiki kokujwayelekile isikhathi eside.
Lezi ziguli ezithola i-insulin zizokhombisa impendulo encishisiwe.
Ngemuva kokuphathwa ngokungena ushukela, ukukhishwa ngokuphelele kwehormoni kuzoba ngaphansi kancane njengomphumela wokuphathwa komlomo. Iziqithi zeLangerhans kanyoni ziba sengcupheni yokuthola ushukela ngaphezulu kweminyaka yesiguli, kepha izinga lokukhiqizwa kwamahomoni aphezulu lihlala lifana.
Inani lama-ketones egazini nomchamo
Imizimba yeKetone ikhiqizwa isibindi njengomphumela we-lipolysis futhi ngenxa ye-ketogenic amino acid. Ngokuntuleka ngokuphelele kwe-insulin, kukhona:
- kusebenze okumenyezelwe kwe-lipolysis;
- i-oxidation ethuthukisiwe yamafutha acid;
- ukuvela kwenani elikhulu le-acetyl-CoA (okunjalo ngokweqile kusetshenziselwa ukwenziwa kwezindikimba ze-ketone).
Ngenxa yokugcwala kwemizimba ye-ketone, i-ketonemia ne-ketonuria kwenzeka.
Kumuntu ophilile, inani lezidumbu ze-ketone lizoba ebangeni lisuka ku-0,3 laya ku-1.7 mmol / l (kuya ngokuthi iyiphi indlela yokunquma le nto).
Imbangela evame kakhulu ye-ketoacidosis yisibalo esidalulwayo sokuxineka kwesifo sikashukela esincike ku-insulin, kanye nesifo sikashukela esingancikileli kwe-insulin, inqobo nje uma amaseli we-pancreatic beta eseqedile futhi eba nokusilela okuphelele kwe-insulin.
I-ketonemia ephezulu kakhulu enenkomba ye-100 kuye ku-170 mmol / L kanye nokusabela okuhle komchamo ku-acetone kuzobonisa ukuthi i-hyperketonemic diabetesic coma iyakhula.
Ukuhlolwa kwe-insulin
Ngemuva kokuzila ukudla, kuzodingeka ukwethula i-insulin enanini lama-PIERESES / kg wesisindo somzimba wesiguli. Uma kunikezwa ukuzwela ngokweqile, khona-ke umthamo wehliselwa ku-0.03-0.05 U / kg.
Isampula ye-venous yegazi evela emithanjeni ye-ulnar yenziwa ngesisu esingenalutho ngasikhathi sinye - imizuzu engu-120. Ngaphezu kwalokho, kufanele uqale ulungiselele uhlelo lokungenisa ngokushesha ushukela egazini.
Kumazinga ajwayelekile, ushukela uzoqala ukukhuphuka ngokushesha ngemizuzu engu-15 ukuya kwengama-20, ufinyelele kumaphesenti angama-50-60 ezinga lokuqala. Ngemuva kwemizuzu engama-90-120, ushukela wegazi uzobuyela kwinani lakhe langempela. Ukwehla kwesimo okuncane kuzoba uphawu lokuncipha kokuzwela kwehomoni. Ukwehla okusheshayo kuzoba uphawu lwe-hypersensitivity.
