IGlucagon ingenye yama-hormone amaningi asemzimbeni wethu. Ubamba iqhaza kwi-carbohydrate nezinye izinhlobo zemetabolism. Ngenxa ye-glucagon, ukulawulwa okunembile kashukela wegazi kungenzeka. Isebenza ngokubambisana ne-insulin: lapho kunesidingo, ivimbela umphumela wayo; ngemuva kokukhiqizwa ngokwejwayelekile kwe-glycemia, kunalokho, kuyakhuthaza. Umuthi nge-glucagon uyindlela ephumelelayo yosizo lokuqala oluphuthumayo, isetshenziselwa ukuqeda i-hypoglycemic precoma ne-coma.
I-Glucagon ne-Metabolism
Amanyikwe enza imisebenzi eminingana. I-Exocrine iqukethe ukukhiqizwa kwejusi yokugaya ukudla, yona ekhishwe ngokusebenzisa imicengezi iye ku-duodenum 12. Umsebenzi we-endocrine ukukhiqiza nokukhipha ngqo egazini le-polypeptides nama-hormone: insulin, glucagon, somatostatin, ghrelin nabanye. Ukuhlanganiswa kwalezi zinto kuhlanganiswe eziqhingini zeLangerhans, imisebenzi ihlukaniswe phakathi kwezinhlobo eziningana zamaseli. I-Glucagon ikhiqizwa ama-a-cell; zibiza cishe ama-20% wenani eliphelele lamaseli ezigcawini zepancreatic.
I-Glucagon ibhekisela kuma-hormone e-polypeptide, ithinta zonke izinhlobo zemetabolism. Umsebenzi oyinhloko we-glucagon ukulwa ne-insulin:
| Uhlobo lomzimba | Isenzo se-Glucagon | Isenzo se-insulin |
| I-Carbohydrate | Kwandisa i-glycemia. Ukuze wenze lokhu, uvuselela i-glycogenolysis (ukuhlehlisa ukubuyela emuva kwe-glycogen kuya glucose) kanye ne-gluconeogenesis (isakhi soshukela ngaphakathi emzimbeni), kuvimbela ukusebenza kwe-insulin. | Yehlisa i-glycemia, ithinta ezinhlangothini eziningana: ikhuthaza ukulethwa kwama-glucose kumaseli wezicubu, ivuselele ukuwohloka kwayo, isiza ukwakha izitolo zikashukela ngendlela ye-glycogen, futhi kuvikele ukwakheka kweglucose emzimbeni womzimba. |
| Lipid | Inomthelela ekubhujisweni kwamafutha kanye nezindleko zayo ezinqubweni zamandla, yenyusa ukugcwala kwemizimba ye-ketone egazini. | Ishukumisa ukwakhiwa kwezicubu ezintsha ze-adipose. |
| Amaprotheni | Unomphumela we-catabolic. | I-hormone isebenza njenge-anabolic: ikhuthaza ukukhula kwemisipha. |
Kumuntu ophilile, ushukela wegazi awuguquki kakhulu, ngemuva kokudla usubuyela esimweni esijwayelekile. Ukulawulwa kwe-glycemia inqubo eyinkimbinkimbi, efaka ubuchopho, ipheshana lesisu, izicubu zomzimba, i-pituitary gland, i-thyroid kanye nama-pancreas, izinso, isibindi nezinye izitho zomzimba. Njengomphumela womsebenzi wabo ohlelekile, izinga le-glucose elilungile lokugaya umzimba lilondolozwa.
Ukuhlangana komzimba
Uma ushukela wegazi wehla ngenxa yokusebenza ngokomzimba noma ukuntuleka kokudla, ukwakheka kwe-glucagon kukhuphuka kakhulu. Kwenzekani lapho lokhu kwenzeka:
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%
- Izitolo ze-Glycogen ezigcinwe esibindini ziyathinteka. I-Glycogen iyabhidlika, iphonswe egazini ngesimo se-glucose, i-glycemia ijwayelekile. Umphumela we-glucagon awusebenzi ngokufakwa kwe-glycogen kwezicubu zemisipha.
- Isibindi siqala ukukhiqiza ngamandla ushukela ovela ku-pyruvate nakwezinye izinto ezingeyona i-carbohydrate.
- Ukusetshenziswa kwe-glucose ekukhiqizweni kwamandla kwehlisa ijubane.
- Izidingo zamandla zomzimba ziqala ukwaneliseka ngenxa yezicubu ezinamafutha, ukugcotshwa kwamafutha acid egazini kuyanda. Ngaso leso sikhathi, imizimba ye-ketone, imikhiqizo yokuwohloka kwamafutha, iqala ukungena egazini.
- Ngokushesha ngemuva kokukhishwa kwe-glucagon, ukukhiqizwa kwe-insulin kukhuphuka. Ngenxa yokusebenza kwabo, i-hyperglycemia iyavinjwa.
- I-glucagon ye-hormone ihlinzeka ukusebenza kwenhliziyo, ukwanda kwamandla nokuvama kwezinkontileka zayo. Ngenxa yokwanda kwengcindezi, umsoco wawo wonke izicubu zomzimba uyathuthuka.
- Ukukhishwa kwe-catecholamines kuyanda, ukuphuma kwemizwa kwenzeka. Umuntu angathola ukwesaba, ukucasuka. Izimpawu ezicace kanjalo zikushukumisela ukuba unake isimo sakho futhi uqede i-hypoglycemia.
- Ekugxileni okuphezulu, i-hormone isebenza njenge-antispasmodic: iphumula imisipha yamathumbu.
I-Glucagon ikhiqizwa ukuphendula ukwehla kwe-glycemia, ukukhiqizwa kwe-insulin okwandisiwe. I-Glucagon synthesis ivuselelwa uhlelo lwezinzwa lwe-autonomic, ngakho-ke ukukhiqizwa kwalo kuyanda ngokusetshenziswa kwe-sympathomimetics kanye ne-adrenostimulants.
Ushukela wegazi ophakeme, ukweqisa kwemizimba ye-ketone namafutha acid emithanjeni yegazi, kanye nezinga eliphakeme le-somatostatin liphazamisa ukukhiqizwa kwe-glucagon.
Ukusetshenziswa kweshukela
Ezigabeni zokuqala, i-hypoglycemia ivinjelwa kalula ukuphathwa ngomlomo kwanoma yiziphi i-carbohydrate ezigaya ukudla okusheshayo: uju, ushukela, amaswidi, amajusi wezithelo. Uma lo mzuzu uphuthelwa futhi isiguli sishubile, kunezindlela ezimbili zokwandisa i-glycemia: ngokuphatha i-glucose noma i-glucagon. Kwi-glucose, ukuphathwa kwe-intravenous kuyadingeka, ngakho-ke, akufanelekile njenge-ejenti elula eshukumisayo esheshayo. Kepha i-glucagon ingavinjelwa intramuscularly, futhi ngale ndlela yokuphatha, iqala ukusebenza ngemuva kwemizuzu engu-5-16.
Ukwakheka kwe-glucagon kuzo zonke izilwane ezincelisayo cishe kuyafana; kubantu, ama-hormone ezilwane angasetshenziswa ngempumelelo. Ukumisa i-hypoglycemia, izidakamizwa ezitholakala ezinkomeni noma ezihlanjeni ezingulube zivame ukusetshenziswa. Isakhiwo se-glucagon saziwa kahle, ngakho-ke, ukwenziwa kwehabhoratri kwehomoni kusungulwe kusetshenziswa izindlela zobunjiniyela bezakhi zofuzo.
Njengamanje, munye kuphela umuthi we-glucagon obhalisiwe kwirejista yezidakamizwa yaseRussia - iGlucaGen HypoKit, ekhiqizwa yinkampani yaseDenmark iNovoNordisk. Into esebenzayo kuyo yi-glucagon hydrochloride, eyenziwe ngezindlela zelebhu, kusetshenziswa uhlobo oluguquliwe lwegciwane le-Escherichia coli. Into esebenzayo isesimweni se-powder, efakwe ebhodleleni lengilazi.
Ikhithi lifaka ibhodlela eline-1 mg ye-glucagon powder, isirinji ene-solvent, icala lepensela lokuthwala umuthi kalula, imiyalo. Intengo yesethi isuka kuma-ruble angama-635 kuya kwangama-750.
Ukuqokwa
Inkambu enkulu yokusebenzisa umuthi ukukhululeka kwe-hypoglycemia ezimweni lapho ukuphathwa ngomlomo kweglucose kungenakwenzeka khona ngenxa yokulahlekelwa ukwazi noma ukuziphatha okungafanele. Imbangela ye-hypoglycemia ingaba ukwanda kwe-insulin, ezinye izidakamizwa zokulwa nesifo sikashukela, indlala, ukucindezela isikhathi eside.
Ezikhungweni zezokwelapha, i-glucagon isetshenziswa njengenye yezokunakekelwa okuphuthumayo okunobuthi ngezidakamizwa zenhliziyo. Ingasetshenziswa futhi ekuhlolweni kwe-gastrointestinal motility njengendlela yokuphumula izicubu zemisipha.
Isenzo
Umsebenzi oyinhloko we-glucagon ukuhlanganisa izitolo ze-glycogen. I-hormone esethuliwe iqala inqubo ye-glycogenolysis, ngenxa yalokho i-glycogen iphulwe phansi esibindini kuya glucose we-phosphorylated. Isikhathi sokuqala kwehomoni sincike kwindlela yokuphatha. Ngoshukela wegazi osungenayo uqala ukukhula ngemuva komzuzu ongu-1, umphumela uhlala kuze kube yimizuzu engama-20. Indlela ye-intramuscular ukuphatha iyakhethwa uma ungeyena uchwepheshe wezokwelapha. I-Glycemia iqala ukwanda ngemuva kwemizuzu engu-5. Imizuzu eyi-10 ngemuva komjovo, isiguli sivame ukuphaphama. Isikhathi sonke sesenzo sifinyelela kumizuzu engama-40. Ngokuphatha okungaphansi, ukufakwa kweglucagon egazini kuhamba kancane - kusuka engxenyeni yehora.
Umuthi awusebenzi ezigulini ezinama-glycogen reserves. Imbangela yokuntuleka kwe-glycogen ingaba yisifo sikashukela nge-hypoglycemia ejwayelekile, ukudla okungenayo i-carbohydrate, ukubulawa yindlala, ukudakwa, ukudakwa, ukuphathwa okuphindaphindiwe kwe-glucagon. I-Glycogen kungenzeka inganele nge-overdose eqinile yemithi enciphisa ushukela.
Isingeniso imithetho
I-Glucagon idinga ukulungiswa ukuphathwa. Inqubo
- Sisusa cap ebhodleleni, kanye cap kusuka inaliti syringe.
- Faka inaliti kwisivalo senjoloba, ukhiphe lonke uketshezi kwisirinji ku-vial.
- Ngaphandle kokususa inaliti, thinta i-vial okwesikhashana ukuze uchithe i-powder.
- Siqoqa ikhambi eliqediwe kwisirinji.
- Phakamisa isirinji ngenaliti phezulu, ukhulule umoya ngokucindezela i-piston.
Umjovo ungenziwa kunoma yisiphi isicubu somzimba esifinyeleleka, kodwa kangcono enkalweni noma ethangeni. Ngokwemiyalo esetshenzisiwe, abantu abadala banikezwa sonke isixazululo, izingane zasenkulisa kanye nezingane ezinesisindo esingaphansi kwamakhilogremu angama-25 - umthamo wehomoni. Lapho nje umuntu onesifo sikashukela ebuyela ezingqondweni, kudingeka anikezwe ushukela ukuze aphuze: isixazululo sokhemisi, itiye elimnandi noma ujusi. Uma kungekho zinguquko esimweni sesiguli imizuzu eyi-10 noma ngaphezulu, udinga usizo oluphuthumayo lwezokwelapha.
Ukuphepha kokuphepha
Lapho usebenzisa i-glucagon, kufanele kucatshangwe okulandelayo:
- Nge-hyperglycemia, i-glucagon ingalimaza isimo sesiguli. Izimpawu ze-hyper ezinzima- ne-hypoglycemia ziyefana, ngakho-ke kuyalulekwa ukukala ushukela ngaphambi kokuphatha i-hormone.
- Isiguli singaba nokubi okwenziwa yizakhi zomuthi, ubungozi bokwethuka kwe-anaphylactic buhlolwe buphansi kakhulu.
- I-hormone ingahanjiswa ngesikhathi sokukhulelwa kanye ne-HB ngaphandle kwengozi enganeni.
- I-Glucagon ayikwazi ukusetshenziswa ne-pheochromocytoma, njengoba lokhu kugqame ngokwanda okukhulu kwengcindezi.
- Ukwethulwa kwalo muthi kungenzeka kungabi nalusizo ngokulawulwa isikhathi eside kwe-indomethacin Ezimweni ezingavamile, i-hypoglycemia iyanda.
- I-hormone ithuthukisa isenzo se-anticoagulants.
Ngemuva kokuphathwa kwe-glucagon, ukushaya kwenhliziyo kunganda, ingcindezi ingakhuphuka, i-tachycardia yesikhashana ingahle ivele, bese kuba ne-nausea. Lapho uthatha i-beta-blockers, lezi zibonakaliso zivame ukuzwakala kakhulu.
