Inqubo yokugaya ukudla kanye nokumuncwa kwezakhi zomzimba ezivela ekudleni kwenzeka ngenxa yejusi le-pancreatic elikhiqizwa ama-pancreas angena amathumbu. I-secretion ye-pancreatic iqukethe ama-enzyme adlala indima phambili ekugayweni kokudla.
Indlela yokukhiqiza, izinhlobo nemisebenzi
I-pancreas iyisitho se-secretion exubekile, ngoba ayakhiqizi kuphela ama-enzymes wokugaya, kepha nama-hormone - i-insulin, i-glucagon ne-lipocaine. I-insulin ne-glucagon ilawula i-carbohydrate metabolism, kanti i-hormone efana ne-lipocaine ibhekene nezinqubo ze-biochemical esibindini. Ama-hormone akhona ku-pancreatic juice futhi asekela ukugaya okujwayelekile emathunjini amancane.
Lapho i-coma yokudla ingena ku-duodenum yamanyikwe, kudluliselwa isifiso lapho kuphendula ngokukhipha inani elidingekayo lokufihla kwe-pancreatic. Inama-enzymes e-pancreatic ngendlela engasebenzi - ama-proenzymes.
I-duct lapho kuphuma ujusi we-pancreatic ungene ku-duodenum 12 ibizwa ngokuthi i-Virsungieva duct futhi itholakala kuwo wonke ubude be-gland. Iphela ngemuva kwamanyikwe nge-sphincter yase-Oddi. Kubantu abaningi, i-Virsungiev duct ixhuma kwi-duct ye-bile ejwayelekile, futhi ifinyelela kwi-duodenum.
Isigaxa senyongo sihlangabezana nokudla okungenayo ngokukhishwa kwe-bile, okuxubana ne-duct ejwayelekile nejusi le-pancreatic. Ngemuva kwalokhu, kusebenze ukusebenza kwama-enzymes wokuhlanza amafutha, amaprotheni nama-carbohydrate. Ngaphansi kwethonya lezinto ze-enzymatic, ama-carbohydrate ayinkimbinkimbi aqhekeza ku-glucose, amaprotheni kuma-amino acid, amafutha kuma-acid acid ne-glycerol.
Ama-enzymes e-pancreatic enza inani elikhulu kakhulu lomsebenzi wokumba ukudla. Ukudla okwenziwa ngama-enzyme kungena emathunjini amancane, lapho izakhamzimba zidonswa ezindongeni zamathumbu zingene egazini, zihambise izitho nezicubu zomzimba.
Njengoba ama-enzyme akhiqizwa umsebenzi wamanyikwe lapho inqubo yokugaya imunca kakhulu, noma yikuphi ukuphazamiseka esithobeni kuthinta inhlala-kahle yomuntu. Kunezinkinga ngamathumbu (i-stool ekhathazekile), kukhona ukubonakaliswa komdanso - ukubhuqa, ukuqhakaza kanye nausea. Ngenxa yokuntuleka kwama-enzymes e-pancreatic, imikhiqizo eminingana ayigaywa, futhi i-pancreatitis iyakhula.
Amaprotheni
Kunezinhlobo ezi-3 eziphambili zama-enzyme - amylase, lipase ne-proteinase. Ama-amylases abhidliza isitashi nama-carbohydrate, umsebenzi we-lipase yi-hydrolysis yamafutha, futhi i-proteinase ibhekene nokuwohloka kwamaprotheni.
Iqembu lama-proteinase lifaka ama-exopeptidases, adiliza izibopho ze-peptide zangaphandle kumaprotheni nama-peptides, nama-endopeptidases, anecala le-hydrolysis yamabhondi e-protein-peptide angaphakathi. Ama-Exopeptidas afaka i-carboxypeptidase A no-B, ama-enzyme e-proteinolytic aphula izibopho ze-peptide futhi ayingxenye yokucasulwa kwe-pancreatic.
Ama-endopeptidases yi-pepsin, i-gastricin ne-chymosin, okugcinwa yi-mucosa esiswini, ne-pancreatic proenzymes trypsin, chymotrypsin ne-elastase. Ama-enzymes ama-gastric agqekeza ama-molecule wamaprotheni ngentshiseko, ekhipha amandla e-hydrochloric acid aze afike ku-95%.
Ngokulandelayo, ama-enzyme e-pancreatic afakiwe emsebenzini, ngaphezu kwalokho aphule amaprotheni emathunjini. Okokuqala, i-trypsin, chymotrypsin ne-elastase zidiliza ama-molecule amakhulu amaprotheni abe amancane - ama-peptides. Ngemuva kwalokho, ngaphansi kwesenzo se-carboxypeptidase, ama-peptides afakwa hydrolyzed kuma-amino acid adonswa udonga lwamathumbu.
Ijusi le-pancreatic liqukethe izinhlobo ezingama-6 zama-protein, ahluka ngesakhiwo sesikhungo esisebenzayo:
- i-serine;
- threonine;
- i-cysteine;
- i-aspartyl;
- i-metalloprotease;
- glutamine.
Kumele kwaziwe ukuthi ama-proteinases ayingxenye yezidakamizwa eziningi ezine-enzyme ezisetshenziselwa ukubuyisela umsebenzi we-pancreatic futhi aqede izimpawu ezingezinhle.
Amylase
Ama-enzymes e-pylreatic e-Amylolytic aphula ukudla okune-sitashi kumashukela alula abizwa ngokuthi i-oligosaccharides. Kuyathokozisa i-amylase ukuthi kuvela isithombe esiphundu esiphundu ngemuva kokudla ukudla okunesitashi - ngokwesibonelo, ilayisi noma amazambane. Le enzyme nayo ikhona kumathe, ngaphansi kwethonya inqubo inqubo yokugaya kuqala.
Emgodleni womlomo, isitashi siphulwe ku-dextrin, futhi i-dextrin nemaltose kwakhiwa ngenxa yokucubungula ama-polysaccharides ngejusi lesisu. Isinyathelo sokugcina ukuhlakanipha kwama-carbohydrate ku-duodenum 12 ku-glucose ne-fructose ngaphansi kwesenzo se-Y-amylase.
Ama-enzymes ama-Amylolytic afaka i-lactase, ephula i-lactose (ushukela) equkethwe kwimikhiqizo yobisi.
Ukuntuleka kwe-enzyme ye-amylase kungabonisa ukuthuthukiswa kwe-pathologies eminingana: i-pancreatitis, mumps (mumps), isifo sikashukela kanye nama-pancreatic tumors.
Lipase
Ama-enzyme e-Lipolytic asebenza njengegalelo le-lipid hydrolysis futhi aphule namafutha atholakele emzimbeni. I-Lipase icushiwe emathunjini futhi iphule ukudla okunamafutha ku-glycerin kanye namafutha aphezulu. Le enzyme ihlukaniswe izingxenye ze-hydrophilic ne-hydrophobic ezisebenza kuphela endaweni enamanzi amaningi. Ngakho-ke, okudingeka kuqala ukugaya kwamafutha kube izingcezu zazo zibe izingcezu ezincane ze-bile - ngaleyo ndlela, indawo yokuxhumana ne-lipase iyanda.
Izinga elikhulayo le-lipase ekuhlolweni kwegazi libonelelwa kuma-pathologies ahlukahlukene emgudu wezinsini kanye nezinso, izifo ze-metabolic (isifo sikashukela, i-gout, ukukhuluphala ngokweqile), i-peritonitis, kanye nemamps. Kwezinye izimo, inkomba ye-lipase inyuka ngenxa yokwelashwa isikhathi eside ngama-barbiturates, ama-narcotic analgesics, uHeparin kanye ne-Indomethacin.
Uma kungekho lipase eyanele emzimbeni, khona-ke imbangela ingaba ukwehla kokusebenza kwe-pancreatic, cystic fibrosis (cystic fibrosis), ukuthuthukiswa kwe-neoplasms enobungozi kunoma yisiphi isitho ngaphandle kwama-pancreas. Kwesinye isikhathi izinga eliphase kakhulu le-lipase kungenxa yokudla okungalinganiseli nokudla kokudla okunamafutha amaningi.
Ukuxilongwa nezimpawu zomsebenzi we-exocrine onciphile
Ukuze unqume ukuthi yimaphi ama-enzymes ama-pancreas angakhiqizi ngenani elanele, kwenziwa izivivinyo zelebhu. Ngokwemiphumela yokuhlolwa kwegazi, umchamo nezindunduma, izifundo ezibalulekile, futhi futhi kucatshangelwa nezimpawu ezikhona, amalungiselelo e-enzyme angabekwa.
Okuqukethwe yi-enzyme kungokulandelayo:
- igazi: amylase - 29-99, lipase - 22-66, trypsin - 19.7 - 30.3 mg / l;
- i-serum yegazi: elastase - 01 - 4 ng / ml;
- umchamo: amylase (diastase) - max 100 amayunithi / l;
- I-coprogram: elastase - kusuka ku-200 mcg / g.
Ama-enzymes e-pancreatic akhiqizwa emangqamuzaneni e-pancreas, bese esebenzisa ama-tubules amancane kakhulu angena emigqonyeni emikhulu ebumba umsele oyinhloko - amaVirsungs
Ukushoda kwama-enzyme e-pancreatic kuholela ekwephuleni okukhulu komsebenzi wokugaya umzimba kanye nomzimba wonke. Esimweni sokukhiqizwa ngokweqile kwama-enzyme, kutholakala ukuvuvukala okukuwo kwamanyikwe - i-pancreatitis. Ukunciphisa ukwakheka kwama-enzyme kusho ukuguquka kwesifo kube ifomu elingamahlalakhona.
Izimbangela ezilandelayo zingaholela ezinguqulweni zokuvuvukala nezonakalisayo kuma-pancreas kanye nokufakwa esikhundleni kwezicubu ze-glandular ngezicubu ze-fibrous:
- ukudla ngokweqile kanye nokuhlukumeza ukudla okunamafutha, iziphuzo ezidakayo;
- ukuba khona kwe-neoplasms - ama-cysts, izimila (zombili nezinsizi), i-fibrosis;
- i-pathology ye-duodenum nepheshana le-biliary;
- ukuhlinzwa kwe-pancreatic.
Ngokushoda kwama-enzymes, kuqhamuka izibonakaliso eziningi zezimpawu:
Ungahlola kanjani amanyikwe- i-polyfecal (inani elikhulu lezinto zokugaya)
- injengephalishi, izihlalo ezikhululekile zombala ophuzi onombala ocwebezelayo, ongaphezulu kawoyela nephunga elingathandeki;
- ukuba khona kwezingcezu zokudla ezingagcinwanga ezindlebeni;
- umuzwa wokugcwala kwesisu kanye nenausea, ukushisa kwenhliziyo;
- ukunambitheka okubi emlonyeni;
- ukwehla kwesifiso sokudla;
- ukuthopha, kuqubuka esiswini;
- ukwehla kwesisindo, i-anemia, ubuthakathaka, ukuqwasha nekhanda;
- ubuhlungu besisu ngemuva kokudla;
- ukungabekezelelani kokudla okunamafutha nezinongo.
Njengoba i-lipase synthesis incishisiwe ikakhulukazi, i-stool disorder ingenye yokuqala - iba i-viscous noma i-semi-liquid. Kuyaqapheleka ukuthi izimpawu cishe ziyefana zombili ngokweqile kwama-enzyme, kanye nokuntuleka. Kodwa-ke, esimweni sokukhiqizwa ngokweqile kwama-enzyme, izinga lokushisa lomzimba lingakhuphuka, kanti nesifo sezinhlungu siba bukhali, siphinyiselwe.
Ukwephulwa komsebenzi we-pocrreas we-pocrreas kudinga ukwelashwa okuphoqelekile, ngoba kungaholela ekwakhiweni kwezifo ezinkulu njenge-pancreatic necrosis, ulcer esiswini, i-hepatitis kanye ne-cirrhosis
Izidakamizwa eziqukethe i-enzyme
Ama-Enzymes ama-pancreas anqunywa ngokwemiphumela yokuhlolwa futhi ngokusekelwe kwizimpawu ezikhona. Uhlobo lomthamo nemithamo kuncike eminyakeni yobudala nesisindo sesiguli, kanye nangefomu lesifo. Ekwelashweni esikhundleni se-enzyme, kusetshenziswa izidakamizwa ezibandakanya i-lipase, amylase ne-trypsin. Lokhu, okokuqala, i-Pancreatin kanye nokuphuma kwayo - i-Creon, iMezim Forte, iPangrol, iPanzitrat, njll.
Imvamisa, odokotela batusa ukuthatha i-Creon, ngoba igxiliswa kangcono futhi inezinzuzo ezinkulu. I-Creon ayitholakali kumathebulethi, kepha kumakhompiyutha avikelwe kakhulu. I-capsule ngayinye iqukethe ama-microspheres amaningi ama-mini, angaguquki ngaphansi kwethonya elinolaka le-hydrochloric acid yesisu futhi ifinyelela lapho iya khona - emathunjini. Ngaphezu kwalokho, ukwakheka kweCreon kufaka phakathi i-dimethicone, enciphisa ukwakhiwa kwegesi.
Izidakamizwa ezimbalwa zinezakhi ezihlanganisiwe, ezifakwe nezakhi ze-bile. Babekelwe ukuphazamiseka okuhlangana kwesibindi kanye nesinye. Izidakamizwa zokuhlanganisa zihlanganisa i-Festal, i-Digestal, i-Kotazim Forte, i-Enzistal.
I-Unienzyme esekelwe epain enzyme yesitshalo ikhuthaza ukugaya ngokuphelele kwamaprotheni, amafutha kanye ne-carbohydrate, ine-monitor, i-laxative necindezelayo yokwakha igesi
Kwi-pancreatitis eyingozi, ama-enzyme inhibitors acindezela umsebenzi wamanyikwe - Somatostatin, Kontrikal, Ingitril, Glucagon, Gordoks, njll asetshenziswa kuqala. Ngemuva kokumisa izimpawu ezinzima, ashintshela emithini equkethe i-enzyme.
Uma kwenzeka amaphutha ekudleni okunempilo noma ngezimpawu ezithambile ze-pancreatitis, ama-enzyme wesitshalo angasetshenziswa - ngokwesibonelo, i-Oraza, Pepfiz, Unienzyme, Wobenzym, Solizim, Abomin.
Izinzuzo zokudla
Ukuthola umphumela omkhulu kusuka ekwelashweni nama-enzyme agents, udinga ukudla okufanele. Kususelwa ezimisweni zokudla No. 5, okushesha kakhulu ukululama:
- ubuncane - inani lokudla ngosuku alikho ngaphansi kwe-5;
- isisindo somuntu okhonzayo akufanele singeqi kuma-200 g .;
- zonke izitsha zithosiwe, kuhhavini noma kubilisiwe;
- izinga lokushisa lokudla - cishe ama-35- 40 °;
- okunamafutha, okuthosiwe, utshwala bunqatshelwe.
Kunconywa inyama enenhlanzi nenhlanzi yezinhlobo ezinamafutha amancane, amaqanda enkukhu, ama-nokunye okufana nokolweni, ama-oatmeal, ama-aphula, ubhanana noshizi we-cottage shizi.
Ukubuyisela umsebenzi we-pancreatic ngokulungiselela i-enzyme, kudingeka ukuhlolwa. Ngokusekelwe emiphumeleni yesiguli ngasinye, kukhethwe irejimeni yodwa yokwelashwa nemithamo yemithi.
