I-Glycated hemoglobin ekuhlolweni kwesifo sikashukela

Amandla okubuyisela i-pathology ye-carbohydrate metabolism ukuphela kwesilinganiso sokuvimbela ukukhubazeka kwasekuqaleni nokufa kwabantu abanezifo zesifo sikashukela. Ubungozi bokuthuthukisa ama-angiopathies phakathi kwamazinga aphezulu we-glycemic sekufakazelwe isikhathi eside. Izinga lesinxephezelo se- “sifo esimnandi” lingahlolwa kuphela ngokuya ngokuhlolwa kwe-glycated hemoglobin (HbA1c). Imvamisa yokuxilongwa ifinyelela izikhathi ezi-4 ngonyaka.

I-Glycated hemoglobin ibizwa ngokuthi inkomba yegazi ene-biochemical ecacisa amanani ajwayelekile eglucose kwikota yokugcina. Yisikhathi lapho imiphumela ingabalwa khona iyindlela ebaluleke kakhulu yokuxilonga, ngokungafani nokuhlaziywa okujwayelekile, lapho inkomba ihlotshaniswa khona nomzuzu wokufaka amasampula ezibonakalayo. Izinga le-glycated hemoglobin ku-mellitus yesifo sikashukela kanye nokuhunyushwa kwemiphumela kubhekwe ngayo endatshaneni.

Izici Zokuxilonga

Amangqamuzana abomvu egazi aqukethe i-hemoglobin A. Nguye, lapho ehlanganiswa noshukela futhi abhekane nochungechunge lokuphendula kwamakhemikhali, abe yi-glycosylated hemoglobin. Ijubane lalokhu "kuguqulwa" kuya ngezinkomba ezinoshukela esikhathini ngenkathi iseli legazi elibomvu liyaphila. Umjikelezo wokuphila kwamangqamuzana abomvu egazi ufinyelela ezinsukwini ezingama-120. Kungalesi sikhathi lapho izinombolo ze-HbA1c zibalwa, kepha kwesinye isikhathi, ukuze bathole imiphumela efanele, bagxile engxenyeni yemijikelezo yempilo yamangqamuzana abomvu egazi - izinsuku ezingama-60.

Izindlela ezilandelayo ze-glycosylated hemoglobin yilezi:

• HbA1a;
• HbA1b;
• I-HbA1c.

Ngokwezibalo, izinga lokuhlolwa kwalesi sikhombiso alidluli i-10% lawo wonke amacala emitholampilo, okungelona iqiniso uma kubonwa ukuthi kudingekile. Lokhu kungenxa yokuqukethwe okunganele kolwazi kweziguli ngenani lomtholampilo lokuhlaziywa, ukusetshenziswa kwabahlaziyi abathwaliwe ngokutholwa okuphansi kanye nenani elinganele lokuxilonga endaweni ethile, okukhuphula ukungathembani kochwepheshe ekuhlolweni.

I-Hyperglycemia - Isixhumanisi Esikhulu Sokwandisa Amazinga weHbA1c

Ubani owabelwa lo msebenzi wokuhlaziya?

Ukulawula akudingeki nje kwisifo sikashukela kuphela, kodwa nakubantu abanempilo abajwayele ukukhuluphala nomfutho wegazi ophezulu. Ukuxilongwa njalo kuboniswa kumacala alandelayo:

• kubo bonke abantu ngemuva kweminyaka engama-45 (njalo emva kweminyaka engama-2-3, uma imiphumela yokuqala yayijwayelekile);
• iziguli ezinezihlobo ezigula ngesifo sikashukela;
• abantu abaphila impilo yokuhlala phansi;
• labo abanokubekezelela ushukela;
• abesifazane abanomlando wesifo sikashukela sokukhulelwa;
• abesifazane ababeletha ingane abanomlando we-macrosomia;
• iziguli ezine-polycystic ovary syndrome;
• iziguli ezinesifo sikashukela i-mellitus (kuqala ukukhonjwa ngokumelene nesizinda sokukhula kwezinkinga ezinzima);
• namanye ama-pathologies (ngesifo se-Itsenko-Cushing's, i-acromegaly, i-thyrotooticosis, i-aldosteroma).

Ukulungiselela ukuqoqwa kwezinto ezibonakalayo akudingekile. Ukuhlolwa kokunqunywa kwe-glycosylated hemoglobin akubekelwe izinsana ezifika ezinyangeni eziyisithupha ubudala.

Igazi leVenous - impahla yokuhlonza amazinga we-HbA1c

Izinzuzo Zokuxilonga

Sekufakazelwe ngokomtholampilo ukuthi ucwaningo olujwayelekile ezigulini ezinesifo sikashukela luyehlisa amathuba okuba nezinkinga, ngoba kungenzeka ukuthi kuhlolwe bese kulungiswa isinxephezelo.

Ngefomu elithembela i-insulin, ubungozi be-retinopathy buncishiswa ngo-25-30%, i-polyneuropathy - ngo-35-40%, i-nephropathy - ngo-30-35%. Ngefomu elizimele le-insulin, ubungozi bokuthuthukisa izinhlobo ezahlukahlukene ze-angiopathy buncishiswa ngo-30- 35%, umphumela obulalayo ngenxa yezinkinga zesifo "esimnandi" - ngo-25-30%, infarction ye-myocardial - ngo-10-15%, nokufa okuphelele - ngama-3-5%. Ngaphezu kwalokho, ukuhlaziya kungenziwa nganoma yisiphi isikhathi, noma ngabe kuthathwa kanjani ukudla. Izifo ezihambisana nawo azithinti ukusebenza kocwaningo.

Imvamisa yezinkomba esegazini

Umphumela wokuxilongwa kwelebhu engenalutho ubhalwe ngo-%. Amanani ajwayelekile wesimo esijwayelekile nabe-pathology anje ngokulandelayo:

• kufika ku-5.7 - kukhombisa imetabolism enhle, ayidingi izinyathelo ezengeziwe;
• ngaphezulu kwe-5.7, kepha ngaphansi kuka-6.0 - asikho “isifo esimnandi”, kepha ukulungiswa kokudla kuyadingeka, ngoba ubungozi bokukhula kwe-pathology buphakeme;
• ngaphezulu kwe-6.0, kepha ngaphansi kwe-6.5 - isimo sokubandlululwa kwe-prediabetes noma ukungasebenzi kahle kweglucose;
• I-6, 5 nangaphezulu - ukutholakala kwesifo sikashukela kuyangabaza.

Ukuxhumana kwe-HbA1c kanye namanani aphakathi kashukela

Izinkomba zesinxephezelo

Ukuxilonga ukuphumelela kokwelashwa kohlobo lwe-1 yesifo sikashukela ngokuya nge-hemoglobin ye-glycated:

• ngaphansi kuka-6.1 - asikho isifo;
• 6.1-7.5 - ukwelashwa kuyasebenza;
• ngaphezulu kwe-7.5 - ukuntuleka kokusebenza kahle kwezokwelapha.

Inqubo yokunxephezela yezifo zohlobo 1 nohlobo 2:

• ngaphansi kuka-7 - isinxephezelo (okujwayelekile);
• 7.1-7.5 - okunciphisiwe;
• ngaphezulu kwe-7.5 - ukubola.

Ingozi yokuhlakulela i-angiopathies ngokumelene nesizinda sohlobo 2 lwesifo sikashukela ngokuya ngezinkomba ze-HbA1c:

• kufinyelela futhi kufaka phakathi i-6.5 - ingozi ephansi;
• ngaphezulu kwe-6.5 - ingozi enkulu yokuthuthukisa ama-macroangiopathies;
• ngaphezulu kwe-7.5 - ingozi enkulu yokuthuthukisa ama-microangiopathies.

Lawula imvamisa

Ukuxilongwa kwelabhorekile kwesifo sikashukela sohlobo 1

Uma isifo sikashukela sitholakala okokuqala, iziguli ezinjalo zitholakala kanye ngonyaka. Ngokuvama okufanayo, labo abangasebenzisi izidakamizwa ukwelashwa kwesifo "esimnandi", kepha bafuna isinxephezelo ngokwelashwa kokudla kanye nokuzivocavoca umzimba okwanele, bayahlolwa.

Endabeni yokusetshenziswa kwama-hypoglycemic agents, isinxephezelo esihle sidinga ukubheka izinkomba ze-HbA1c kanye ngonyaka, nokunxeshezelwa okungalungile - kanye ezinyangeni ezi-6. Uma udokotela enquma amalungiselelo e-insulin, khona-ke ukuhlaziya uma kwenzeka isinxephezelo esihle senziwa izikhathi ezi-2 kuye kwezi-4 ngonyaka, ngesilinganiso esanele - amahlandla ama-4 ngonyaka.

Kubalulekile! Izikhathi ezingaphezu kwezi-4 zokuxilonga akunangqondo.

Izimbangela zokuguquguquka

Inani elikhulayo le-glycosylated hemoglobin alinakubonwa hhayi kuphela ngesifo "esimnandi", kodwa futhi nangemuva lezimo ezilandelayo:

• i-hemoglobin ephezulu ye-fetus ezinganeni ezisanda kuzalwa (isimo siwokomzimba futhi asidingi ukulungiswa);
• ukwehla kwenani lensimbi emzimbeni;
• ngokumelene nesizinda sokususwa kwensimbi.

Amazinga ancishisiwe noma andisiwe wezinkomba - isikhathi sokulungiswa kwawo

Ukwehla kokuxineka kwe-HbA1c kwenzeka ezimeni ezinjalo:

• ukuthuthukiswa kwe-hypoglycemia (ukwehla kweglucose yegazi);
• amazinga aphakeme e-hemoglobin ejwayelekile;
• isimo ngemuva kokulahlekelwa kwegazi, lapho uhlelo lwe-hematopoietic lusebenze;
• i-hemolytic anemia;
• ukuba khona kwezihlakala zegazi nokuphuma kwegazi lesimo esibuhlungu noma esingamahlalakhona;
• ukwehluleka kwezinso;
• ukumpontshelwa igazi.

Izindlela Zokuxilonga Nezabahlaziyi

Amasu amaningana asetshenziswa ukuthola ama-glycated hemoglobin indices; ngenxa yalokho, kunenombolo yabahlaziyi abathile kwendlela ngayinye yokuxilonga.

I-HPLC

Ingcindezelo ephezulu ye-ion yokushintshanisa i-chromatography kuyindlela yokuhlukanisa into eyinkimbinkimbi ibe izinhlayiya ngazinye, lapho i-medium main iyi-ketshezi. Sebenzisa abahlaziyi D 10 no Variant II. Ukuhlolwa kwenziwa emalabhoratri amaphakathi nezibhedlela zezifunda nasedolobheni, ezikhungweni zokuxilonga ezithinta abantu abancane. Indlela iqinisekiswe ngokuphelele futhi iyazenzakalela. Imiphumela yokuxwaya ayidingi ukuqinisekiswa okwengeziwe.

I-Immunoturbudimetry

Indlela yokuhlaziya esekwe ohlelweni lwe-antigen anti-anti classical. Ukuphendula okuxubile kuvumela ukwakheka kwezixakaxaka lapho, lapho zivezwa izinto ze-luminescent, zinganqunywa ngaphansi kwefotomu. Ngokucwaninga, i-serum yegazi iyasetshenziswa, kanye nezinto ezikhethekile zokuxilonga kubahlaziyi be-biochemical othomathikhi.

Abahlaziyi bezinto eziphilayo abanobuciko obukhulu - amathuba okuqashelwa okuphezulu kokuxilongwa

Lolu hlobo lokucwaninga lwenziwa endaweni yokucwaninga ngama-biochemical nge flow ephakathi nendawo noma ephansi yokuhlaziya. Ububi bale ndlela yisidingo sokulungiswa kwesampula.

I-Afcon ye-chromatography

Indlela yokucwaninga ethize esekwe ekuxhumaneni kwamaprotheni anezinto ezithile ze-organic ezingezwe kwimvelo yezinto eziphilayo. Ukuhlaziya ukuhlolwa - In2it, NycoCard. Indlela ikuvumela ukuthi uxilonge ngqo ehhovisi likadokotela (elalisetshenziswa emazweni aseYurophu).

Ukuhlolwa kusetshenziswa ezimeni ezihlukile, kunendleko ephezulu yokudla, ngakho-ke akuvamile ukusetshenziswa. Ukuhunyushwa kwemiphumela kwenziwa ngudokotela ohambele obeke ucwaningo. Ngokuya izinkomba ezitholakele, amanye amaqhinga wokuphathwa kweziguli ayakhethwa.