Kwenziwa kanjani ukuhlolwa kokubekezelela kwe-glucose (imiyalo, umbhalo)

Ukudla okungaphezulu kwengxenye yabantu abaningi kuqukethe ama-carbohydrate, adonswa emgudwini we-gastrointestinal futhi akhishwa egazini njenge-glucose. Ukuhlolwa kokubekezelela kwe-glucose kusinikeza imininingwane yokuthi lingakanani futhi ngokushesha kangakanani umzimba wethu okwazi ukucubungula leli glucose, ulisebenzise njengamandla womsebenzi wesistimu yemisipha.

Igama elithi "ukubekezelela" kulokhu lisho ukuthi amaseli omzimba wethu akwazi kangakanani ukuthatha ushukela. Ukuhlolwa ngesikhathi kungavikela isifo sikashukela kanye nezifo eziningana ezibangelwa ukuphazamiseka kwe-metabolic. Ucwaningo lulula, kepha lufundisayo futhi lunokuphikisana okumbalwa.

Kuvunyelwe kubo bonke abantu abaneminyaka engaphezu kwengu-14 ubudala, kanti ngesikhathi sokukhulelwa kuvunyelwe njalo futhi kwenziwa okungenani kanye ngesikhathi sokukhulelwa kwengane.

Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule

• Ukwehlela ushukela -95%
• Ukuqedwa kwe-vein thrombosis - 70%
• Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
• Ukuqeda umfutho wegazi ophakeme - 92%
• Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%

Izindlela zokuhlola ukubekezelela ushukela

Umnyombo wohlolo lokubekezelela i-glucose (GTT) uqukethe ukulinganisa ushukela wegazi okuphindaphindiwe: okokuqala ngqa ngokuntuleka koshukela - esiswini esingenalutho, khona-ke - isikhathi esithile emva kokuba ushukela engena egazini. Ngakho-ke, umuntu angabona ukuthi amaseli omzimba ayayibona nokuthi ahlala isikhathi esingakanani. Uma isilinganiso senziwa kaningi, kungenzeka nokwakha ijika leshukela, elibonakalisa konke ukwephulwa okungenzeka.

Imvamisa, nge-GTT, ushukela uphuzwa ngomlomo, okuwukuthi, vele uphuze isixazululo sawo. Le ndlela iyindalo ebabazekayo kakhulu futhi ikhombisa ngokuphelele ukuguqulwa koshukela emzimbeni wesiguli ngemuva, ngokwesibonelo, i-dessert eningi. I-glucose nayo ingangenwa ngqo emithanjeni ngomjovo. Ukuphathwa kwe-Intravenous kusetshenziswa ezimweni lapho kungakwazi ukwenziwa ukuhlolwa kokubekezelela kwe-glucose ngomlomo - ngokufaka ubuthi nokuhlanza okuhlangana, ngesikhathi se-toxicosis ngesikhathi sokukhulelwa, kanye nezifo zesisu namathumbu okuhlanekezela inqubo yokufaka egazini.

Kudingeka nini i-GTT?

Inhloso eyinhloko yokuhlola ukuvimbela ukuphazamiseka kwe-metabolic kanye nokuvikela ukuqala kwesifo sikashukela. Ngakho-ke, ukuhlolwa kokubekezelela i-glucose kufanele kudluliselwe kubo bonke abantu abasengozini, kanye neziguli ezinezifo, imbangela yazo engaba ushukela omude, kodwa ukhuphuke kancane ushukela:

• ukhuluphele, BMI;
• umfutho wegazi ophikelelayo, lapho ingcindezi ingaphezulu kwe-140/90 iningi losuku;
• izifo ezihlangene ezibangelwa ukuphazamiseka kwe-metabolic, njenge-gout;
• ukutholakala kwe-vasoconstriction ngenxa yokwakheka kwama-plaque nama-plaque ezindongeni zawo zangaphakathi;
• ukusolwa kwe-metabolic syndrome;
• ukuqina kwesibindi;
• kwabesifazane - i-polycystic ovary, ngemuva kwamacala okuphuphuma kwesisu, ukungasebenzi kahle, ukuzalwa kwengane enkulu kakhulu, isifo sikashukela sokukhulelwa;
• ukubekezelelwa kwe-glucose okubekiwe ngaphambili ukuthola amandla esifo;
• izinqubo ezivame ukuvuvukala emgodini womlomo nangaphezu kwesikhumba;
• ukulimala kwezinzwa, imbangela yakho engakaze icaciswe;
• ukuthatha ama-diuretics, estrogen, glucocorticoids ahlala isikhathi esingaphezu konyaka;
• isifo sikashukela i-mellitus noma i-metabolic syndrome emndenini oseduze - abazali nezingane zakwabo;
• I-hyperglycemia, isikhathi esisodwa esiqoshwe ngesikhathi sokuxineka noma ukugula kakhulu.

Lapho i-GTT inqatshelwe

Ukuhlolwa kuyama uma, esiswini esingenalutho, izinga le-glucose elikulo (i-GLU) lidlula umkhawulo we-11.1 mmol / L. Ukudla okwengeziwe kwamaswidi okulesi simo kuyingozi, kubangela ukungaboni kahle futhi kungaholela ekhefeni le-hyperglycemic.

Contraindication for test glucoseokubekezelela:

1. Kwezifo ezithathelanayo noma ezithathelanayo.
2. Kwi-trimester yokugcina yokukhulelwa, ikakhulukazi ngemuva kwamasonto angama-32.
3. Izingane ezingaphansi kweminyaka eyi-14.
4. Esikhathini sokwanda kwe-pancreatitis engapheli.
5. Lapho kukhona izifo ze-endocrine ezibangela ukwanda kwe-glucose yegazi: Isifo sikaCushing, umsebenzi owandisiwe we-thyroid, i-acromegaly, pheochromocytoma.
6. Ngenkathi uthatha umuthi ongahlanekezela imiphumela yokuhlolwa - ama-hormone e-steroid, ama-COC, ama-diuretics eqenjini le-hydrochlorothiazide, diacarb, ezinye izidakamizwa ze-antiepileptic.

Ezitolo zamakhemisi nasezitolo zemishini yezokwelapha ungathenga isisombululo se-glucose, nama-glucometer ashibhile, futhi nabahlaziyi bezinto eziphilayo abanokutholakala ababona ukubalwa kwegazi okungama-5-6. Ngaphandle kwalokhu, ukuvivinywa kokukhuthazelela i-glucose ekhaya, ngaphandle kokuqashwa ngudokotela, kuyenqatshelwe. Okokuqala, inkululeko enjalo ingaholela ekuwohlokeni okubukhali kuze kufike e-ambulensi.

Okwesibili, ukunemba kwawo wonke amadivayisi aphathekayo awanele kulolu hlaziyo, ngakho-ke, izinkomba ezitholakala elabhoratri zingahluka kakhulu. Ungasebenzisa la madivaysi ukunquma ushukela wokuzila futhi ngemuva komthwalo weglucose wemvelo - ukudla okujwayelekile. Kungakuhle ukuyisebenzisa ukuthola imikhiqizo enomphumela omkhulu kumazinga kashukela wegazi futhi yenze ukudla komuntu siqu ukuvikela isifo sikashukela noma isinxephezelo saso.

Izici ezithinta ukuthembeka kwe-GTT

Lapho uphasa isivivinyo, isilinganiso sokuqala se-glucose senziwa esiswini esingenalutho. Lo mphumela ubhekwa njengezinga lapho izilinganiso esele ziyoqhathaniswa. Izinkomba zesibili nezilandelayo zincike ekungenisweni okufanele kweglucose nokunemba kwemishini esetshenzisiwe. Ngeke sibathonye. Kepha ukuthembeka kwesilinganiso sokuqala iziguli ngokwazo zinomthwalo wemfanelo ngokuphelele. Izizathu eziningi zingahlanekezela imiphumela, ngakho-ke, ukulungiselela i-GTT kufanele kunikezwe ngokukhethekile.

Ukunemba kwemininingwane etholakele kungaholela ku:

1. Utshwala ngosuku olwandulela ucwaningo.
2. Isifo sohudo, ukushisa okukhulu, noma ukuphuza okunganele kwamanzi okuholele ekuphelelwe ngamandla emzimbeni.
3. Ukusebenza kanzima okunzima noma ukuqeqeshwa kanzima ngezinsuku ezi-3 ngaphambi kokuhlolwa.
4. Izinguquko ezimangalisayo ekudleni, ikakhulukazi ezihambisana nokuvinjelwa kwama-carbohydrate, indlala.
5. Ukubhema ebusuku nasekuseni ngaphambi kwe-GTT.
6. Izimo ezicindezelayo.
7. Amakhaza, kubandakanya namaphaphu.
8. Izinqubo zokubuyisa umzimba emzimbeni ngesikhathi sokusebenza.
9. Ukuphumula kombhede noma ukwehla okubukhali komzimba ojwayelekile womzimba.

Inqubo Yokuhlola

Naphezu kweqiniso lokuthi isivivinyo sokubekezelela i-glucose silula kakhulu, ilabhorethri kuzofanela ichithe cishe amahora ama-2, lapho kuzohlaziywa khona inguquko esezingeni likashukela. Ukuhamba ngezinyawo ngalesi sikhathi ngeke kusebenze, ngoba ukuqapha kwabasebenzi kuyadingeka. Iziguli zivame ukucelwa ukuba zilinde ebhentshini elisendleleni yehholo lelebhu. Ukudlala imidlalo ethokozisayo ocingweni nakho akukufanele - izinguquko ezingokomzwelo zingathinta ukuthathwa koshukela. Ukukhetha okuhle yincwadi yokuqonda.

Izinyathelo zokuthola ukubekezelela ushukela

1. Umnikelo wegazi wokuqala wenziwa impela ekuseni, esiswini esingenalutho. Isikhathi esivela ekudleni kokugcina silawulwa ngokuqinile. Akufanele zibe ngaphansi kwamahora angama-8, ukuze kusetshenziswe ama-carbohydrate asetshenzisiwe, futhi kungabi ngaphezu kwe-14, ukuze umzimba ungaqali ukulamba futhi uthathe i-glucose ngamanani angewona ajwayelekile.
2. Umthwalo weglucose ingilazi yamanzi amnandi edinga ukuphuzwa kungakapheli imizuzu emi-5. Inani le-glucose kulo linqunywa ngokuqinile ngokwahlukana. Imvamisa, ama-85 g e-glucose monohydrate ancibilikiswa ngemanti, elihambisana negremu emsulwa engama-75. Kubantu abaneminyaka eyi-14-18, umthwalo odingekile ubalwa ngokuya ngesisindo sabo - i-1.75 g ye-glucose emsulwa ekhilogremu ngalinye. Isisindo esingaphezu kwamakhilogremu angama-43, kuvunyelwe umthamo wabantu abadala ojwayelekile. Kubantu abakhuluphele, umthwalo unyuka uye kuma-100 g. Lapho uphathwa ngaphakathi, ingxenye yeglucose incishiswa kakhulu, okuvumela ukuthi kubhekwe ukulahleka kwayo ngesikhathi sokugayishwa.
3. Ngokuphindaphindiwe nikela ngegazi amahlandla ama-4 ngaphezulu - njalo ngehora lehora ngemuva kokuzivocavoca. Amandla wokunciphisa ushukela angahlulelwa ekwephulelweni ekusebenzeni kwawo. Amanye ama-laboratories athatha igazi kabili - esiswini esingenalutho nangemva kwamahora ama-2. Umphumela wokuhlaziywa okunjalo kungenzeka ungathembeki. Uma i-peak glucose esegazini ivela ngesikhathi sokuqala, izohlala ingabhalisiwe.

Ukuhlolwa koshukela egazini

Njengamanje, cishe alikho igazi elithathwa emunweni. Emalabhorethri anamuhla, indinganiso isebenza ngegazi elibuhlungu. Lapho uyihlaziya, imiphumela inemba ngokwengeziwe, ngoba ayixubekile noketshezi kanye ne-lymph, njengegazi le-capillary elivela emunweni. Kulezi zinsuku, uthango oluvela emthanjeni alulahlekelwa yilutho lapho inqubo ingena - izinaliti ezicijile nge-laser zenza ukubhoboza cishe kungabi buhlungu.

Lapho uthatha igazi ukuthola isivivinyo sokubekezelela ushukela, ubekwa kumashubhu akhethekile aphathwa ngemithi yokubulala amagciwane. Inketho enhle kakhulu ukusetshenziswa kwezinhlelo ze-vacuum, lapho igazi ligeleza ngokulinganayo ngenxa yokuhluka kwengcindezi. Lokhu kugwema ukubhujiswa kwamangqamuzana abomvu egazi kanye nokwakheka kwama-clots, angahlanekezela imiphumela yokuhlolwa noma kungenze kube nzima ukufeza.

Umsebenzi womsizi welebhu njengamanje ukugwema ukulimala kwegazi - i-oxidation, glycolysis kanye nokuqina. Ukuvimbela i-glucose oxidation, i-sodium fluoride isezindabeni. Ama-ion fluoride akulo avimbela ukuqhekeka kwe-molecule yeglue. Izinguquko ku-hemoglobin ye-glycated zigwenywa ngokusebenzisa amashubhu apholile bese kubekwa amasampula emakhazeni. Njengama-anticoagulants, i-EDTU noma i-sodium citrate iyasetshenziswa.

Ngemuva kwalokho ibhubhu lifakwa ku-centrifuge, lihlukanisa igazi libe yi-plasma kanye nezinto ezakhiwe. I-Plasma idluliselwa kwi-tube entsha, futhi ukuzimisela kweshukela kuzokwenzeka kuyo. Izindlela eziningi zenzelwe le nhloso, kepha ezimbili zazo manje sezisetshenziswa kuma-laboratories: i-glucose oxidase ne-hexokinase. Lezi zindlela zombili ziyi-enzymatic; isenzo sazo sisuselwa ekuphendukeni kwamakhemikhali kwama-enzyme ane-glucose. Izinto ezitholwe njengomphumela walokhu kuguqulwa zihlolwa kusetshenziswa i-photometer ye-biochemical noma kubahlaziyi abazenzakalelayo. Inqubo enjalo yokuhlola igazi esekwe futhi eyenziwe kahle ikuvumela ukuthi uthole idatha ethembekile ekwakhiweni kwayo, uqhathanise imiphumela evela emalabhorathri ahlukahlukene, futhi usebenzise amazinga ajwayelekile amazinga weglucose.

I-GTT ejwayelekile

Isimo se-glucose amasampula egazi lokuqala ne-GTT

Isimo se-glucose yesampula yegazi lesibili nelilandelayo nge-GTT

Imininingwane etholakele ayiyona eyokuxilonga, lolu nje ulwazi ngodokotela ohlanganyelayo. Ukuqinisekisa imiphumela, kuhlolwa okuphindaphindwe kakhudlwana kweglucose, kunikelwa ngegazi kwezinye izinkomba, kunikezwe ukuhlolwa kwesitho okungeziwe. Kungemva nje kwazo zonke lezi zinqubo lapho singakhuluma khona nge-metabolic syndrome, ukuthikamezeka kwe-glucose futhi, ikakhulukazi, isifo sikashukela.

Ngokuxilongwa okuqinisekisiwe, kuzodingeka ukuthi uphinde ucabangele impilo yakho yonke: buyisela isisindo kokujwayelekile, khawulela ukudla kwe-carbohydrate, ubuyisele ithoni yemisipha ngokusebenza komzimba okujwayelekile. Ngaphezu kwalokho, iziguli zinikezwa izidakamizwa ezinciphisa ushukela, futhi ezimweni ezinzima, imijovo ye-insulin. Isilinganiso esikhulu sikashukela egazini sibangela ukukhathala okungapheli nokunganaki, kulimaza umzimba ngaphakathi, kuvuse isifiso esinamandla sokunqoba ushukela omningi kakhulu. Umzimba ubukeka umelana nokululama. Futhi uma uvumela ukuvumela lesi sifo ukuba sikhukhumele - kunengozi enkulu ngemuva kweminyaka emi-5 yokuthola izinguquko ezingenakuguqulwa emehlweni, ezinso, ezinyaweni, nokukhubazeka.

Uma ulilungu leqembu elisengozini, isifo sikashukela kufanele siqale ngaphambi kokuthi uvivinyo lokukhuthazelela ushukela lubonise ukungasebenzi kahle. Kulokhu, amathuba okuphila isikhathi eside nenempilo ngaphandle kwesifo sikashukela andiswa kakhulu.

Ukuhlolwa kokubekezelela kwe-glucose ngesikhathi sokukhulelwa

Uma umuntu ethi abesifazane abakhulelwe abadingi ukuya kwi-GTT, empeleni lokhu akulungile!

Ukukhulelwa - isikhathi sokuhlelwa kabusha kwamakhadinali komzimba ukuze uthole ukondleka kahle kwesibeletho futhi usinikeze umoya-mpilo. Kunezinguquko ezenzeka emzimbeni we-glucose metabolism. Engxenyeni yokuqala yesikhathi, i-GTT ngesikhathi sokukhulelwa inika amanani aphansi kunokujwayelekile. Ngemuva kwalokho kuvulwa umshini okhethekile - ingxenye yamaseli emisipha iyeka ukuqaphela i-insulin, kunoshukela omningi egazini, futhi ingane ithola amandla amaningi egazini ukuze ikhule.

Uma le ndlela ihluleka, bakhuluma ngesifo sikashukela sokukhulelwa. Lolu uhlobo oluhlukile lwesifo sikashukela, esenzeka kuphela ngesikhathi sokukhulelwa kwengane, futhi sidlule ngokushesha nje emva kokuzalwa kwengane.

Izindlela zokuxilonga zesifo sikashukela sokukhulelwa

Uma i-glucose esheshayo ingaphezulu kwe-7, futhi ngemuva komthwalo - 11 mmol / l, kusho ukuthi isifo sikashukela sasikhishwa ngesikhathi sokukhulelwa. Amanani aphezulu anjalo ngeke akwazi ukubuyela kokujwayelekile ngemuva kokuzalwa kwengane.

Sizothola ukuthi i-GTT kufanele yenziwe isikhathi esingakanani ukuze ilandelele ukuphazamiseka kwe-metabolic ngesikhathi. Ukuhlolwa kokuqala kweshukela kunqunywa ngokushesha ngemuva kokuxhumana nodokotela. I-glucose yegazi noma i-glycated hemoglobin inqunywa. Ngokwemiphumela yalolu cwaningo, abesifazane abakhulelwe abane-mellitus yesifo sikashukela bebodwa (ushukela ongaphezulu kwe-7, i-glycated hemoglobin engaphezu kuka-6.5%). Ukukhulelwa kwabo kwenziwa nge-oda ekhethekile. Lapho sebethole imiphumela engathandeki yomngcele, abesifazane abakhulelwe basengozini yokuba nesifo sikashukela sokukhulelwa. Ukuhlolwa kokubekezelela ushukela usheshe wenziwa kwabesifazane kuleli qembu, kanye nalabo abahlanganisa izici eziyingozi eziningana zesifo sikashukela.

Ukuhlolwa kokukhulelwa kwamaviki angama-24-28 kuyimpoqo kuwo wonke umuntu, kuyingxenye yokuhlolwa kokuhlolwa.

Ukuhlolwa kokubekezelela kwe-glucose kwenziwa ngesikhathi sokukhulelwa ngokunakekelwa okukhulu, ngoba ushukela omningi ngemuva kokuzivocavoca ungalimaza ingane. Ukuhlolwa okusheshayo okwenziwa kuqala ukuthola amazinga eglucose, futhi kuphela ngama-indices ayo ajwayelekile i-GTT ivunyelwe. I-glucose ayisetshenziswa ngaphezu kwe-75 g, ngezifo ezithathelwanayo ezincane kunazo zonke ukuhlolwa kukhanseliwe, ukuhlaziya kwenziwa ngomthwalo ongafika emavikini angama-28, ezimeni ezihlukile - kuze kufike ku-32.

Ukufingqa, incazelo emfushane yokuhlaziywa

Hlala uphilile futhi ugcina ushukela wegazi lakho.

Kuzoba wusizo: Imithetho eyisisekelo yokunikela ngegazi ngoshukela, ukuthola umphumela onembe kakhudlwana - //diabetiya.ru/analizy/analiz-krovi-na-sahar.html