Isifo sikashukela se-Steroid (sincike kwe-insulin) sivela ngenxa yokuthola amazinga aphezulu e-corticosteroids egazini, ahlala lapho isikhathi eside kakhulu.
Imvamisa kakhulu, iba ngumphumela wokuvela kwezinkinga ezinkulu zezifo lapho kukhona ukukhiqizwa kwamahomoni okushesha.
Kodwa-ke, noma kunjalo, kuvame ukubonakala ngemuva kokwelashwa okuhlala isikhathi eside ngemithi ye-hormonal. Kungakho ukugula lokhu kubizwa nangokuthi uhlobo lomthamo wesifo sikashukela.
Ishukela likashukela ngemvelaphi yalo alilona iqembu le-pancreatic zezifo. Kubalulekile ukuqaphela ukuthi ekuqaleni ayihlotshaniswa nezinhlobo ezahlukahlukene zokuphazamiseka kwamanyikwe.
Yiziphi izidakamizwa ezingadala lesi sifo?
Abantu abangahlushwa i-carbohydrate metabolism ephazamisekile, uma kwenzeka kunamaphesenti amaningi ama-steroid e-steroid, bangathola ifomu lesifo elibi, elihamba ngokushesha ngemuva kokukhanselwa. Iphuzu elibalulekile ukuthi cishe isigamu sabo bonke abaguli abaphethwe yilesi sifo bathola ukuguquka kusuka kwifomu elizimele le-insulin liye kwifomu lesifo elihambisana ne-insulin.
IGlucocorticosteroids (Dexamethasone, Prednisolone, Hydrocortisone) isetshenziswa njengezidakamizwa ezisebenzayo futhi ezinamandla zokulwa nokuvuvukala kwezifo ezinjalo:
- isifuba somoya;
- isifo samathambo;
- ukwephulwa kokusebenza okujwayelekile kwemisebenzi yokuvikela umzimba;
- i-sclerosis eminingi.
Isifo sikashukela seSteroid singenzeka ngenxa yokusetshenziswa isikhathi eside kwezidakamizwa ezinjengokuvimbela inzalo ngomlomo kanye ne-thiazide diuretics.
Imithamo enamandla kakhulu ye-corticosteroids ingasetjenziswa ngesikhathi sokwelashwa, okuhloswe ngaso ukudambisa ukuvuvukala ngemuva kokuhlinzwa, lapho kwenziwa khona ukufakelwa kwezinso.
Ngemuva kokuhlinzwa okungathi sína lokhu, iziguli kufanele zisebenzise izidakamizwa ezifanele kukho konke impilo yazo ukucindezela imisebenzi yokuvikela umzimba. Banenkambiso yezinqubo zokuvuvukala ezingathinta izitho ezidlulisiwe.
Izimpawu zokugula okwavela ngenxa yokwelashwa okuhlala isikhathi eside kwe-steroid zigcizelela ukuthi iziguli zihlukaniswa njengabantu abasengozini enkulu.
Ukuqeda ngokuphelele ukwenzeka kwesifo sikashukela, abantu abakhuluphe ngokweqile kufanele bazinakekele futhi baqale ukulahlekelwa ngamakhilogremu angeziwe.
Kepha labo abanesisindo esijwayelekile, udinga ukuqala ukudlala imidlalo futhi ulungise kancane indlela abadla ngayo nsuku zonke, unezela kuyo amakhambi amasha, imifino nezithelo.
Izimpawu
Lesi sifo sehlukile ngoba sinezimpawu zesifo sikashukela sohlobo lokuqala nolwesibili.
Lesi sifo sivela eqinisweni lokuthi inani elihlaba umxhwele le-corticosteroids liqala ukulimaza ngenkuthalo amaseli we-beta we-pancreas.
Baqhubeka nokukhiqiza ama-pancreatic hormone alawula i-carbohydrate metabolism isikhathi esithile.
Ngemuva kwesikhathi esithile, inani le-hormone elikhiqizwayo lincipha kakhulu futhi nokuzwela kwezicubu kulo kukhubazekile. Lesi yisimo sohlobo 2 sikashukela. Kamuva, inani elithile lamaseli we-beta achithwa ngokuphelele, okuholela ekumisweni ekukhiqizeni i-insulin okusebenzayo. Kulokhu, ukugula kuqala ukuqhubeka ngesimo sesifo sohlobo lwesifo sikashukela esincike kakhulu ku-1.
Izimpawu zesifo sikashukela seSteroid zinokulandelayo:
- ukwanda kokuchama;
- ukoma okukhulu;
- ukukhathala.
Njengomthetho, izimpawu zesifo sikashukela se-steroid zilula, ngakho-ke iziguli azibanaki kakhulu.
Baqala ukunciphisa umzimba ngokushesha, njengasoshukela wohlobo 1. Ukuhlolwa kwegazi akusisizi ngaso sonke isikhathi ukuthola lesi sifo ngesikhathi.
Kuyaqabukela, ukuhlushwa kweglucose kungaba phezulu kakhulu. Ngaphezu kwalokho, inani le-propanone kumchamo nalo lihlala lisendaweni eyamukelekayo.
I-pathogenesis yesifo sikashukela se-steroid
Ukungasebenzi kahle kwamaprotheni okususelwa phansi ngenxa yokuba khona kwama-glucocorticoids ngokweqile kuholela ekwakhekeni ushukela kusuka kuma-amino acid.Inqubo yokuvuselela i-glucose-6-phosphatase esibindini ngala ma-hormone isiza ukukhipha i-glucose kulesi sitho. Phakathi kokunye, ama-glucocorticoids anciphisa kakhulu umsebenzi we-hexokinase, obambezela ukumuncwa kweglucose.
Ekhuluma ngesifo sikashukela se-steroid, i-biochemistry yalesi sifo ukuthi ukuvuselelwa kokuqhekeka kwamaprotheni kungaholela ekukhuleni kwayo, ngenxa yalokho kukhiqizwa inani elikhuluhali lamafutha mahhala egazini. Ngenxa yalokhu, inani loshukela egazini liyanda.
Ngamanye amagama, isifo sikashukela esiyi-steroid siyindlela yomtholampilo yalesi sifo, esivela ngenxa yokuqukethwe okuphezulu kwama-hormone e-adrenal egazini. Lokhu kuyasebenza nasekwelashweni nezidakamizwa eziqukethe lezi zinto.
Ukwelashwa
Uma kwenzeka ukuthi i-insulin iyeke ukukhiqizwa emzimbeni, le ndlela yalesi sifo iqhubeka ngendlela efanayo nesifo sikashukela sohlobo lokuqala. Kepha ngakho konke lokhu, unezimpawu zesifo sikashukela sohlobo 2.
Ukulungiselela i-Glucophage
Ukwelashwa ngokuqondile kuya ngokuthi hlobo luni lokwephulwa okukhona kulesi siguli. Kubantu abakhuluphele ngokweqile, kepha basaveza i-insulin, ukudla okhethekile nemithi yokuthi amazinga ashukela aphansi afanelekile. IGlucophage neTiazolidinedione ziphakathi kwazo. Imithamo "emincane" yesondlo se-insulin kwesinye isikhathi ibekiwe.
Uma kwenzeka kuphazamiseka i-pancreatic, ukwethulwa komthamo we-insulin kuyinika amandla okusebenza ngomthwalo ophansi. Lokhu kungenzeka kuphela uma amaseli we-beta asaqhubeka nomsebenzi wawo. Ukudla okhethekile kungasiza ngokuphelele ekwelashweni, kuqede ngokuphelele ukusetshenziswa kwemikhiqizo equkethe ama-carbohydrate.
Kubantu abane-coefficient efanelekile yomzimba, ungasebenzisa ukudla No. 9, neziguli ezikhulu, ukudla uNo. 8.
Uma umuntu onesifo sikashukela se-steroid, ama-pancreas engasakwazi ukukhiqiza ngokuzimela i-insulin, khona-ke kunqunywa ngendlela yemijovo egunyaziwe.
Kulokhu, umuntu akufanele akhohlwe ngokuqashwa njalo kwamazinga kashukela wegazi. Inqubo yokwelashwa kumele yenziwe ngendlela efanayo nesifo sikashukela sohlobo 1. Ngaphezu kwalokho, kungale ndlela yalesi sifo ukuthi akunakwenzeka ukubuyisela amaseli we-beta afile ngaphambili.
Isifo salolu hlobo sitholakala lapho ukugxila kweglue glucose kuqala ukwedlula uphawu lwe-11.5 mmol ngemuva kokudla, futhi phambi kwayo kungaphezu kuka-6 mmol. Ngemuva kokuthola izimpawu ezethusayo, kuyaphuthuma ukuxhumana nodokotela wakho ukuze akusize.
Okokuqala, uchwepheshe kufanele azikhiphe ngokuphelele zonke izifo ezifanayo ezifakiwe kuleli qembu. Inqubo yokuqeda lesi sifo ingaba yindabuko futhi ibe nokuqondisa okunamandla. Lokhu kokugcina kusebenza kakhulu, kepha ngasikhathi sinye kudinga amakhono athile okuzithiba ogulayo.
Indlela yendabuko yokwelashwa isuselwa kunqubo-ndlela efana nezinyathelo ezifanayo zohlobo lwesibili.
Uma ama-pancreas ethintekile, kunqunywa umthamo omncane we-insulin. Ukwelashwa, ama-hypoglycemic kanye nama-ejenti ama-hormone asetshenziswa, njengokuthi, ngokwesibonelo, i-Glucofage.
Uma isiguli sinefomu nje lesifo nje elincane, khona-ke ama-sulfonylureas angasetshenziswa, ongasiza ekuqedeni. Kepha le ndlela inemiphumela emibi, eyingozi kakhulu futhi engalindelekile okukhona kuyo ukuqanjwa kwe-myocardial infarction.
Lokhu kungenxa yokuthi i-carbohydrate metabolism iyawohloka kakhulu, ngenxa yalokho kukhona ukwephulwa okuyingozi ekusebenzeni kwezitho nezinhlelo. Kungenxa yalesi sizathu ukuthi lesi sifo kancane kancane singaphenduka ifomu elibizwa ngokuthi yi-insulin.
Kwezinye izimo ezikhethekile, ikhambi elilungile kunazo zonke ukuhlinzwa. Izicubu ezingadingekile zisuswa ku-adrenal gland uma kutholakala i-hyperplasia.
Ngemuva kokuhlinzwa, isimo sesiguli siba ngcono kakhulu, futhi uyalulama. Noma kunjalo, kuyadingeka ukulandela izincomo zikadokotela oholayo ukuze isimo sihlale sizinzile.
Amavidiyo ahlobene
Siyini isifo sikashukela futhi selashwa kanjani? Izimpendulo kuvidiyo:
Ukwelashwa kwesifo sikashukela se-steroid kuzophumelela kuphela uma isiguli singazinaki izincomo eziphuthumayo zochwepheshe lapho kubhekwa khona yena. Kubalulekile lapho kuvela izimpawu zokuqala ngesikhathi ukuze uthintane nesikhungo sezokwelapha ukuze uhlolwe futhi uthole ukuthi isifo sakho sitholakele yini. Ngemuva kwalokho, udokotela uzonikeza ukwelashwa okufanelekile, okuzosiza kuphela uma zonke izidingo zibhekwe ngokuqinile.
Ungakhohlwa ukuthi isifo sikashukela se-steroid senzeka ngenxa yokusebenzisa isikhathi eside izindlela zokuvimbela inzalo zama-hormone nezinye izidakamizwa ezifanayo. Futhi engcupheni bangabantu abakhuluphele ngokweqile. Ngakho-ke, ukuze uvikele lesi sifo, kufanele ulahle ukutholakala kwezidakamizwa okungahleliwe (uma bekungazange kunqunyelwe udokotela) bese uqala ukubheka owakho umsoco. Kuyadingeka ukucebisa ukudla kwakho ngemikhiqizo ewusizo, ikakhulukazi, imifino, izithelo, amakhambi, ama-legumes, futhi futhi ususe ngokuphelele ushukela oyingozi, ongalethi inzuzo.
