ISIFO SIKASHUKELA SESTEROID - SIYINI? IZIMPAWU KANYE NE-BIOCHEMISTRY

Send

Ngendlela yayo yomtholampilo, isifo sikashukela i-steroid i-mellitus (DM 1) yesibili, kepha ihlanganisa izici zezinhlobo zokuqala nezesibili.

Isizathu sokubukeka ukubakhona isikhathi eside egazini senani elikhulu lama-corticosteroids (ama-hormone akhiqizwa yi-adrenal cortex), okuholela ekungasebenzi kahle kwamanyikwe ngenxa yomonakalo wamaseli awo.

ISymbomatology

Isici sesifo sikashukela se-steroid, esibizwa nangokuthi isifo sikashukela sokwelapha, ukushuba kwezimpawu okuphansi.

Esikhathini sokuqala kwesifo, ukweqisa kwama-corticosteroids kubangela ukulimala kumaseli we-endocrine pancreas, kepha ukukhiqizwa kwe-insulin kusaqhubeka. Lobu bunzima - lesi sifo sesiqale ukugcwala, kepha izimpawu zisabonakala zibuthakathaka kakhulu futhi isiguli asiphuthumi ukuyofuna usizo lodokotela.

Ngokumiswa ngokuphelele kokukhishwa kwe-insulin, kuvela izimpawu zesifo sikashukela esijwayelekile:

I-Polyuria
I-Polydipsia;
Ubuthakathaka
Ukukhathala;
Isimo esibi sokujwayelekile.

Ukwehla kwesisindo okungazelelwe akuyona into ejwayelekile kwabanesifo sikashukela, njengoba kunezinguquko ezingazelelwe nge-glycemia. Ukuqoqwa koshukela ne-acetone emanzini afundisiwe okuphuma emzimbeni (igazi nomchamo) kuvame ukusondela kokujwayelekile. Lokhu kwenza kube nzima ukuthola ukuxilongwa okuyikho.

Izizathu zokubukeka

Isifo sikashukela seSteroid senzeka ngenxa yokungezwani kwama-corticosteroids egazini lomuntu. Izizathu zalokhu kweqisa zingaba zangaphandle nezendabuko.

Ngezimbangela ze-endo native, ama-hormone ngokweqile angavela ngenxa yezifo zohlelo lwe-endocrine. Nge-exo native - ukwanda kwama-hormone kwenzeka ngemuva kokusetshenziswa isikhathi eside kwemithi ye-glucocorticosteroid.

Okwemvelo

Isifo sikashukela seSteroid singadala:

I-Thiazide diuretics (Ezidrex, Hypothiazide).
Izidakamizwa ezisetshenziswa ekwelapheni imizwa yokungezwani komzimba, i-polyarthritis, i-diphtheria, inyumoniya, umkhuhlane we-typhoid, i-mononucleosis kanye nezinye izifo eziningi, kubandakanya ne-autoimmune. Lesi sigaba sezidakamizwa sifaka iBetaspan, Dexamethasone, Prednisolone, Dexon, Anaprilin.
Izidakamizwa ezilwa nokuvuvukala ezisetshenziswa ngemuva kokuhlinzwa kokufakwa kwezinso.
Amaphilisi okulawula ukuzala.

Izimbangela ezingaphandle

Ukwephulwa kwe-pituitary gland kukuthinta kabi ukumelana kwezicubu namaseli omzimba ku-insulin. Phakathi kwezimo ezinjalo ze-pathological, i-Itsenko-Cushing syndrome ivame ukuhlangana nayo, ebonakala ngokufihla ngokweqile kwe-cortisol ye-hormone yi-adrenal cortex.

Isifo esinjalo sivame ukuziveza siphikisana nesizinda sesifo se-Itsenko-Cushing, esihlukile kulokho kuhlangana komqondo wokuthi i-adrenal cortex ivela okwesibili.

Imbangela yokuqala yalesi sifo i-pituitary microadenoma.

Isifo i-Graves '(isifo esinobuthi), isifo se-autoimmune thyroid lapho ukuphuma kwe-insulin kanye nokunyuka kweglucose egazini nakho kungaholela ekwakhiweni kwesifo sikashukela sezidakamizwa.

Kubalulekile! Uma ngesikhathi sokuphathwa kwezidakamizwa ze-glucocorticoid ezigulini i-carbohydrate metabolism emzimbeni ayiphazamiseki, ukugcwala ngokweqile kwama-homons kungaqedwa ngokukhansela ukusetshenziswa kwemithi futhi kufakwe okunye esikhundleni se-analogues ephephile.

Iqembu lengozi

Isifo sikashukela seSteroid asakheki kuzo zonke iziguli ezithatha umuthi we-corticosteroid. Kunezici ezithile ezandisa amathuba okuthuthukisa lolu hlobo lwesifo:

isakhi sofuzo;

Isisindo esiningi;
I-Hypodynamia;
Ukudla okungenampilo.

Ingozi yokuba nesifo sikashukela yanda ngezikhathi uma kuba nokuqagela kofuzo lapho abazali besiguli benomlando walesi sifo.

Isisindo ngokweqile, okungavela futhi ngenxa yokungasebenzi komzimba, kuholela ekhuphukeni kwegazi le-insulin engasebenzi, i-lipids, i-cholesterol, ushukela, futhi kwephula nomfutho wegazi. Ngokwanda kwenkomba yesisindo somzimba, ebalwa ngokuhlukanisa isisindo ngesikwele sokukhula ngamamitha, kuya kuma-27 kg / m2, lokhu kuholela ekunciphiseni kokuzwela kwezicubu ukungena kwe-insulin.

Ukubekwa phambili koshukela omsulwa, odonswa kalula (ushukela wezimboni, uju), ama-carbohydrate alula kanye nokwehla kwamaprotheni ekudleni kuphazamisa izinqubo ze-metabolic emzimbeni, ezingadala ukukhuluphala.

Ukuxilonga

Ubunzima bokuxilongwa kwalesi sifo ukuthi izinkomba zokuhlolwa kwegazi kanye nomchamo zingadlula kuphela izinkambiso ezimisiwe. Indlela elungile yokuxilonga iyindlela yokuhlola ukubekezelela ushukela, enquma ukuba khona kwe-prediabetes.

Ukuxilongwa kwesifo sikashukela i-mellitus singenziwa ngokwandisa ushukela wegazi kusuka ku-6 mmol / L esiswini esingenalutho kuya ku-11 mmol / L ngemuva kokulayisha ngesisombululo se-glucose. Ngemuva kwalokho uhlobo lwayo luyatholakala.

Ukunquma isifo sikashukela se-steroid, kwenziwa ezinye izivivinyo: ama-17-ketosteroids nama-17-hydroxycorticosteroids emchameni, ukuhlolwa kwegazi ngezinga lama-hormone akhiqizwa yi-adrenal cortex, i-pituitary gland.

Indlela ebalulekile yokuxilonga ukuhlolwa kwegazi okune-biochemical, okungukuthi, izinkomba ezinjengama-glucose, i-glycated hemoglobin, i-insulin, i-C-peptide, i-lipoproteins, i-triglycerides, i-fructosamine, i-pancreatic peptide.

Ukwelashwa

Isifo sikashukela seSteroid siphathwa ngokwemithetho efanayo nesifo sikashukela sohlobo 2 kanye nenqubo yokuthola isinxephezelo iyafana.

Ukwelashwa okusebenzayo kwesifo sikashukela se-steroid ngale ndlela:

Ukuhoxiswa kwe-corticosteroids;
Ukuphathwa kwe-insulin;
Ukudla;
Ukuthatha izidakamizwa ze-antidiabetesic;
Ukungenelela kokuhlinzwa.

Ngohlobo lwangaphandle lokuthuthuka kwalesi sifo (ukusetshenziswa kwama-glucocorticoids), kuyadingeka ukumisa ukuphatha kwawo futhi ukhethe izithonjana eziphephile. Izigaba ezilandelayo zokwelapha ukudla, ukusetshenziswa kwama-hypoglycemic agents kanye nemithamo ye-insulin yokwelapha.

Nge-endo native hypercorticism, lapho isifo sikashukela se-steroid sibangelwa ukungasebenzi kahle komzimba uqobo, ukungenelela kokuhlinzwa kuvame ukwenziwa, okubandakanya ukukhipha izicubu ngokweqile kwizindlala ze-adrenal.

Ukusetshenziswa kwezidakamizwa ze-antidiabetic kufanele kuhlanganiswe nemijovo ye-insulin, ngaphandle kwalokho umphumela we-hypoglycemic wokwamukelwa kwabo uzoba omncane noma ungabikho ngokuphelele. Lokhu kungenxa yokuthi i-insulin ivumela isikhathi esithile ukusebenza kahle kwamaseli e-beta futhi iwanikeze amandla okubuyisela imisebenzi yawo yobumfihlo.

Ukudla okuphansi kwe-carbohydrate kubandakanya ukwehlisa inani lama-carbohydrate adliwe ngosuku nokwandisa ukungena kwamaprotheni nemifino. Njengomphumela wokulandela ukudla okunjalo, inhlala-kahle yomuntu iyathuthuka, isidingo somzimba somuthi we-insulin nowehlisa ushukela siyancipha, kanti ukuphakala kwamazinga kashukela ngemuva kokudla kuncishisiwe.

Izidakamizwa ezinciphisa ushukela azikwazi ukwelapha ushukela ngokuphelele, ukuthathwa kwazo kuholela ekuthuthukiseni inqubekela phambili nokwanda kokusebenza.

Ukuhlukaniswa kwezidakamizwa

Izidakamizwa ezinciphisa ushukela ziza ngamaqembu amaningi:

Okutholakala eSulfonylurea;
Ama-Thiazolidinediones;
Ama-inhibitors we-Alpha glucosidase;
Meglitinides;
Incretinomimetics.

Izithako ze-sulfonylureas zivame ukusetshenziselwa ukwelashwa kwesifo sikashukela sohlobo 2, nesifo sikashukela esingesoshukela. Indlela yesenzo sabo ukuvusa ama-B-cell engxenye yama-pancreas, ngenxa yalokho lapho kuba khona ukugqugquzelwa nokwanda ukukhiqizwa kwe-insulin.

Odokotela abakhona banikeza izidakamizwa ezinjengeGlycvidon, Chlorpropamide, Maninil, Tolbutamide, Glipizide.

I-Meglitinides (Nateglinide, Repaglinide) ikhulisa ukukhiqizwa kwe-insulin namazinga aphansi we-glucose.

I-Biguanides (Bagomet, Metformin, Siofor, Glucofage) - izidakamizwa isenzo sayo sihlose ukuvikela ukukhiqizwa kwe-glucose (gluconeogeneis) nokwenza ngcono inqubo yokusetshenziswa kwayo. Uma kungekho imijovo ye-insulin, umphumela we-Biguanides awuboniswa.

I-Thiazolidinediones noma i-glitazone (i-Pioglitazone neRosiglitazone) yandisa ukuzwela kwemisipha, izicubu ze-adipose nesibindi ku-insulin, ngokwenza kusebenze ama-receptors abo, futhi futhi kuthuthukise i-lipid metabolism.

I-Alpha-glucosidase inhibitors (i-Voglibosis, iGlucobay, iMiglitol) yehlisa ijubane ukuqhekeka kwama-saccharides, inciphisa ukwakheka nokufakwa kwe-glucose emathunjini.

I-asccinomimetics (i-Liraglutid, i-Exenatide, i-Sitagliptin, i-Saksagliptin) iyisigaba esisha semithi yokulwa ne-antidiabetic, inqubo yesenzo esekwe ezimeni zama-incretins, ama-hormone atholakala ngezinhlobo ezithile zamangqamuzana amancane amathumbu ngemuva kokudla. Ukuphuza kwabo kuthuthukisa ukukhishwa kwe-insulin, kwehlisa amazinga kashukela.

Isifo sikashukela seSteroid siboniswa inkambo ezinzile futhi engeneme. Ukwelashwa kwesifo esinjalo kufanele kube okuphelele futhi kungafaki imijovo ye-insulin nokusetshenziswa kwezidakamizwa ezokwehlisa ushukela kuphela, kepha futhi nokudla nendlela yokuphila esebenzayo.

Send