Isho ukuthini imiphumela yokuhlaziywa kwe-glycosylated hemoglobin: izinkomba ezandayo nezincishisiwe

Isikhathi eside, isifo sikashukela singenzeka ngesimo sefent, noma isiguli singaziqapheli izimpawu eziyingozi.

Lokhu kuholela emiphumeleni enzima yezempilo engenakuphikwa.

Ukuhlaziywa kwe-glycosylated hemoglobin kuyisifundo esifundisa kunazo zonke ekutholakalweni kwesifo sikashukela, kufaka phakathi nezigaba zaso zokuqala. Cabanga ukuthi unganikela kanjani ngegazi, nokuthi imiphumela ingakhuluma ngani.

I-biochemistry yegazi ku-HbA1C: yini?

Izinga le-hemoglobin ye-glycated likuvumela ukuthi uthole ukuthi iyiphi ingxenye ye-hemoglobin ebopha i-glucose ngesikhathi sokuphendula, lapho ushukela nama-amino acid angena khona lapho ushukela ungena ngaphakathi kolwelwesi lwe-erythrocyte.

Le nqubo yenzeka ngokuqhubekayo emzimbeni, kepha uma ushukela uhlala “weqa” egazini, khona-ke izinga leshukela ngaphakathi kweseli elibomvu legazi lizinze (lihlala lilingana nezinyanga ezi-4).

Ezimweni eziningi, kuhlaziywa inqubo ethile yesifo sikashukela esisolisayo, kanye nokubheka inqubekela phambili yesifo esivele satholakala se-endocrine.

Ngokuphikisana nokuhlaziywa okusheshayo okujwayelekile kokuthola izinga le-glucose egazini, inkomba efana ne-glycosylated hemoglobin kaningi inokufundisa.

Nawa umehluko obalulekile:

• kukhombisa inani elijwayelekile ezinyangeni ezintathu ezedlule, okusho ukuthi ukukhohlisa udokotela ngokumane uhlale ekudleni izinsuku eziningana ngaphambi kokuthatha ukuhlaziya kuzokwehluleka;
• i-hemoglobin ye-glycated cishe ayixhomekeki kwithonya lezinto zangaphandle, ngoba ikhombisa inani elijwayelekile (ukuhlolwa okuvamile okusheshayo "kungakhohlisa" ngenxa yokugula kwangaphambilini, ukucindezelwa, ukusebenza ngokomzimba noma ezinye izinto);
• I-glycosylated hemoglobin ivumela udokotela ukuthi abone ngokunembe kakhudlwana izinqubo ze-carbohydrate metabolism emzimbeni.

Ukuthola isithombe somtholampilo, odokotela banquma i-hemoglobin encodce HbA1C. Ukuhlolwa okunjalo kuyabiza kakhulu (intengo ephezulu ukuphela kwendlela yendlela) kunokuhlaziya okusheshayo okujwayelekile, kodwa kufanele kwenziwe uma udokotela ephikelela kukho.

Indlela yokunqunywa kwe-glycosylated hemoglobin egazini

Eminyakeni engamashumi amathathu edlule, le ndlela yokucwaninga yasungulwa.

Sibala izindlela ezisetshenziswa njengamanje:

1. ukusebenza okuphezulu kwe-chromatography ye-liquid. Izinzuzo: imiphumela efanelekile enqunywe yi-analyzer kumodi ezenzakalelayo. Cons: indlela ebiza kakhulu;
2. I-ion exchange chromatography. Lolu cwaningo ngolunye lwezinto eziyinkimbinkimbi kakhulu, kuphela ama-laboratories ambalwa anemishini edingekayo;
3. ingcindezi ephansi ye-ion exchange chromatography. Ukuhlaziywa kulungiselelwe ngemizuzu emihlanu nje kuphela, ukufakwa ngokwakho kungokweselula. Enye yezindlela ezisheshayo nezindala kakhulu;
4. immunoturbidimetry - Enye indlela enembayo ephezulu (inani lentengo lincane kancane kune-chromatography);
5. amadivaysi ephathekayo. E-Russia, abakamukeli ukusatshalaliswa okubanzi, noma kunjalo, abaningi phesheya banabahlaziyi bezindlu zeselula.

Izinkomba zokuhlaziywa

Uma kunesidingo, izinga le-hemoglobin ye-glycosylated inqunywa ezinganeni, ebusheni, kanye nakubantu abadala, kufaka phakathi abesifazane abakhulelwe:

• ukusolwa kwesifo sikashukela noma okunye ukuphazamiseka kwe-carbohydrate metabolism;
• ukukhulelwa kwabesifazane abasengozini (njengomthetho, ukuhlaziya kuhlelwe amasonto ayi-10);
• Uhlobo 1 olutholakele nohlobo 2 lwesifo sikashukela;
• kwesinye isikhathi izinga le-hemoglobin ye-glycated linqunywa nge-hypertension.

Ungayivivinya kanjani i-glycosylated hemoglobin?

Akudingekile ukuza elabhoratri esiswini esingenalutho - ungadla ibhulakufesi ngaphambi kokuthatha igazi.

Ukuzivocavoca ngokomzimba, ukucindezelwa, ukugula kwangaphambilini, njll. Futhi akulithinti kakhulu izinga lenkomba ehlaziywayo. Isiguli sidinga into eyodwa kuphela: vakashela elebhu noma ngasiphi isikhathi esikahle.

Uthango lwenziwe kusuka emithanjeni noma emunweni (kuya ngokuthi ihlaziyiphi lifakwe esikhungweni esithile sezokwelapha). Ukuhlaziywa kuthatha izinsuku ezintathu kuya kwezine.

Ukuthola imiphumela yocwaningo: izinkambiso ngeminyaka

Udokotela uqinisekisa ukungabi bikho ngokuphelele kwengozi yokuthola isifo sikashukela uma inkomba ingeqi inani lama-5.7%.

Ngakho-ke, nakhu okufanele kube yi-hemoglobin ye-glycated

Ngakho-ke, kubantu abasha abanempilo, inani le-6.5% lithathwa njengokujwayelekile. Lo ngumkhawulo ophezulu. Uma kudlulwa, kutholakala ukuthi kutholakele isifo sikashukela: isifo sikashukela.

Ukusondela ku-6.5% sekuvele kuwuphawu olwethusayo. Ngakho:

• kukholelwa ukuthi ingozi yokuba nesifo sikashukela ayikho ngokuphelele i-glycated hemoglobin ifinyelela ku-5.7%;
• isikhathi sokuphumula ukusuka ku-5.7 kuye ku-6% sibonisa ukuthi kufanele unake ukudla nendlela yokuphila;
• ezingeni le-6.1 nele-6.4, ubungozi besifo sikashukela bukhuphuka kakhulu, kungcono ukubonana nodokotela.

Ngokuqondene nezinga le-hemoglobin ye-glycated ezinganeni, lapha izinkambiso azifani kubantu abadala - ezinganeni ezihlanzekile ngokuphelele ezingenasengozini yokuthola ukuphazamiseka kwe-carbohydrate metabolism, inkomba akufanele idlule ku-5.7%. Ngenxa yezizathu zokuphila, ezinganeni ezinyangeni zokuqala zokuphila, inani le-6.0% lithathwa njengokujwayelekile.

Uma izinkomba zanda, kusho ukuthini lokhu?

Kulesi simo, udokotela usola ukuthuthukiswa kwesifo sikashukela futhi unquma ezinye izivivinyo. Kodwa-ke, kude namazinga aphezulu we-hemoglobin ephakeme njalo kukhombisa ukwephulwa kwe-carbohydrate metabolism.

Ezinye izizathu ezenza ukuthi imiphumela yokuhlolwa kwe-hemoglobin glycated iphakanyiswe:

• ukuntuleka kwethafa;
• ukulahleka kwegazi okunzima okuza ngocwaningo;
• ukuntuleka kwe-iron anemia;
• ubuthi botshwala;
• i-uremia (isifo sezinso);
• ukwehluleka kwezinso;
• amazinga akhuphukayo we-fetus hemoglobin.

Ukwanda kwezinga lesikhombisi esihlaziyiwe kuwuphawu oluyingozi oludinga ukwelashwa kanye nokulungiswa kwendlela yokuphila.

Izizathu zokwehlisa inkomba ngezansi kokujwayelekile

Uma ukuhlaziywa kwe-biochemical kukhombisa ukuthi i-glycogemoglobin "ayifiki" okujwayelekile - kusho ukuthini?

Sibala izizathu okungenzeka zehlise inkomba ngezansi kweleveli:

• i-hypoglycemia;
• ukulahleka kwegazi kwakamuva;
• ukungasebenzi kahle kwamanyikwe;
• ukwehluleka kwesibindi noma kwezinso;
• ukucekelwa phansi kwangaphambi kwesikhathi kwamangqamuzana abomvu emzimbeni.

Ukwehla kwezinga le-hemoglobin ye-glycated emzimbeni kunophawu olubunjiwe. Isiguli sinezinkinga zokuzela, ukubona okufiphele, ukukhathala okukhulu, ukungakhathaleki nokufoka.

Izindleko zokuhlaziya

Izindleko eziphansi kakhulu zezinsizakalo ezikhungweni zezokwelapha zezwe ngama-ruble angama-400, okuyisilinganiso - cishe ama-ruble ayinkulungwane.

Ngenxa yezindleko eziphakeme, ukuzimisela kwezinga le-hemoglobin ye-glycosylated kusetshenziswa kaningi kakhulu kunokuhlola ushukela wegazi ojwayelekile. Kodwa-ke, kuyasiza ukuqonda ukuthi ngokwemininingwane yokuqukethwe, kanye nekhono "lokubonisa" isifo sikashukela ezigabeni zokuqala, indlela ayinakulingana.

Amavidiyo ahlobene

Mayelana nokuhlaziywa kwe-hemoglobin ye-glycosylated kuvidiyo:

Dlulisa ukuhlaziywa, futhi uzokwazi kahle uma unengozi yokuthola ukuphazamiseka kwe-endocrine.