Izimpawu zesifo sikashukela zinamacala amaningi futhi ahlukahlukene.
Kubandakanya ukuphazamiseka kwazo zonke izinhlobo zezicubu zomzimba, kubandakanya namafutha, ukubonakaliswa okungaba yizo zombili izinhlayiya zezicubu ze-adipose, kanye nokuhlelwa kabusha kwayo okungafaniyo - i-lipohypertrophy.
Kubonakala kakhulu ngesimo samafutha angaphansi, kepha kuthinta ushintsho kwezinye izindawo zomzimba.
Yini le
Umqondo we-lipodystrophy (ukukhubazeka okunamafutha) ufaka ukuhlukahluka okukhulu kakhulu ekuqaleni kanye nokubonakaliswa kokuphazamiseka kwe-metabolic kwezicubu ze-adipose, okusebenza njengesici esibaluleke kakhulu sokuba khona kwanoma yisiphi isitho.
Ngakho-ke, ukuba khona kwesendlalelo esinamafutha okumbatha ngokuqinile izinso ngaphezulu kwekhompiyutha yayo ethintekayo kunomthelela ekuqiniseni kwezinga lokushisa ngaphakathi kwesitho, ngasikhathi sinye ukusibeka endaweni yaso efanele (ukuvimbela ukuthi kungenzeka kwehle).
Kodwa noma ngabe isitho singenalo ungqimba lwamafutha abonakalayo, sikhona emazingeni wamangqamuzana - alikho iseli elilodwa elingakwenza ngaphandle kokufakwa ungqimba lwe-lipid ekwakhiweni kwesitho saso.
Umqondo ojwayelekile we-lipoatrophy uyakwazi ukunika umzimba womsubathi owakha umzimba onomsipha wokuphefumula owaziwayo. Kepha ngoyedwa “kepha”: noma kungabikho ngokuphelele kwamafutha angaphansi, usenawo. Nge-lipoatrophy, ukuba khona kwayo akunakwenzeka ngokomgomo, ngaphandle kokudalwa kwezimo ezikhethekile zokudla okunempilo nokunikezwa kwe-assortment ecebile yezitsha neziphuzo ezinomthelela ekuqongeleleni kwamafutha (ubhiya, okhilimu, uwoyela, ama-muffins).
Isici esiyingqayizivele se-lipodystrophy kusuka ku-ejstrophy ejwayelekile ukukhula okujwayelekile kwezicubu zomzimba ngaphandle kwezimpawu zokuvinjwa.
I-Lipohypertrophic dystrophy yisimo sokuqhekeka kwamafutha angaphansi, impela okuphambene maqondana noku okungenhla.
Isampula ye-biopsy (into ebonakalayo eyi-micros samp etholwe ngokubeka engxenyeni engasho lutho yesitho) ibonisa isithombe hhayi kuphela sobukhona obukhulu bezicubu ze-adipose esethanjeni elingapheli, kodwa futhi nobuningi be-fibrous, fibre-free inethiwekhi ekhula kuwo, ekhombisa ubunzima bezinqubo ze-metabolic kanye nokubekeka phambili ukwakheka kwezindawo zokuwohloka okujulile.
Ividiyo emayelana ne-etiology ye-lipodystrophy:
Izinhlobo nezici ze-pathology
Yikuphi ukukhetha okuxoxwe ngakho ngenhla - izinhlobo zokuwohloka kwamafutha?
Esimweni sokuqala, kunokungavikeleki kwesitho (izicubu, isikhumba, isibindi) emiphumeleni yezinto eziphikisayo:
- ingaphandle (izinga lokushisa eliphakeme noma eliphansi, kusuka ekulimaleni);
- okungaphakathi (izinguquko ekwakhekeni kwegazi eligelezayo ngesimo sokuqukethwe okuphansi noma okuphezulu kweglucose, ubuthi nezinye izinto ezikulo, noma ukuba khona kokutheleleka kulo).
Okwesibili kufakazela ukwehlukaniswa okujulile kwesiza sesitho noma indawo kusuka ezinhlakeni ezingomakhelwane, okuthi, uma kuyinto evumayo, kuholele ekwakhiweni komjondolo onamandla wokuqothula, futhi esimweni esingenanzuzo esingakanani, ukufa kwezicubu ezisebenzayo esikhundleni saso ngesibazi.
Izizathu zokubukeka
Ngokwenzeka nokuqhubeka kwe-lipodystrophy, kunezizathu:
- isimo ngobuzwe (okulungiselelwe ngokuqondile, noma ngokuzalwa);
- ukuhlanekezelwa kwezinqubo zokuphila emzimbeni (kutholakala).
Isigaba sokuqala sifaka izimo ezibangelwa:
- i-lipodystrophy engxenye yomndeni;
- Isifo seBerardinelli-Seip.
Okwesibili kuningi, kufaka i-lipodystrophy:
- ingxenye (eqhelelene, ephathelene nezitho zomzimba ngazinye), izigaba ze-Barraquer-Simons syndrome;
- okwenziwe ngokujwayelekile (okubandakanya umzimba wonke);
- infantile (isimilo sezinsana) isisu se-centrifugal;
- i-atrophy eyakhelwe indandatho yezicubu ze-adipose (Ferreira-Markish syndrome);
- isimo se-insulin;
- I-HIV ehlobene
- ezinye izinhlobo ezinesimo sendawo yenqubo.
I-Lipodystrophy kushukela
Isimo sihambisana nokuchayeka emzimbeni we-insulin, obhekele:
- ukushintshwa kwama-carbohydrate hhayi kuphela, kepha futhi namafutha namaprotheni;
- ukulawulwa kwezinqubo zokukhula nokuhlukaniswa kwezicubu (ukuhlukaniswa nokwakheka kwesakhiwo esifanele, okuqinisekisa ukunemba komsebenzi wabo);
- inqubo yokufunda izakhi zofuzo, ngaphandle kwalokho i-DNA synthesis ayinakwenzeka.
Lapho kukhona isifo sikashukela i-mellitus, kuvela i-insulin ukumelana nethishu - ukusabela kwezicubu ezingajwayelekile ngendlela yokuziba i-hormone noma ukuphenduka okuphambene nakho.
Ngokuphathelene nomphumela wawo kwezicubu ze-adipose ezinamijovo ejwayelekile, lokhu kusho ukwenzeka kwe-factori degeneration yayo kokubhekise kwi-hyper- ne-hypotrophy.
Ngokubukeka, kubukeka njengokuvela “kwezixha” ezinonile ezinamanzi ngaphansi kwesikhumba noma kubonakaliswa “imigodi” -mikhonto esikhunjeni.
Ukwakheka komlando wezifunda eziwohlokile:
- yandisa inqubo yokufakwa kwe-insulin kulezi zindawo;
- akuvumeli ukufezekisa ukuqala nokuphela kwesenzo se-insulin esikhathini esichazwe ngokunembile (ikakhulukazi ezimweni ezinezidakamizwa zesikhathi eside).
Izimpawu nokuboniswa
Ngokunikwa ukuthi ukuwohloka kwamafutha kubangelwa ngokuqondile ngemijovo ye-insulin, akunakwenzeka kuhlobo lwesifo sikashukela sohlobo lwe-II (olungathembekile kwe-insulin).
Zihambisana kuphela nenkambo yesifo sikashukela sohlobo I, esibonakalisiwe:
- ukoma;
- isifo sikashukela (ukuchama okuvame kakhulu ngemithamo emikhulu yomchamo);
- ukunambitheka okumnandi komchamo (kuchazwe ngokuqukethwe ushukela);
- isifiso sokungahluzeki ngaphandle kokuqaqamba;
- indlela yokunciphisa umzimba
I-Lipodystrophy yezitho zangaphakathi ayiveli ngaphandle (kuphela ukuphazamiseka kwemvelo kwemisebenzi yalezi zitho ezibangelwa yiyo kungalandelelwa). Kepha maqondana nesikhumba, akunakucatshangwa ukuthi ungaboni ukuqhamuka kwawo.
Enganeni enesifo sikashukela esincike ku-insulin, ukuqala kwe-lipodystrophy kungabonakala ngemuva kwenkathi ehlukile kusukela ekuqaleni komjovo: kusukela endabeni yamaviki kuya eminyakeni eyi-8 noma eyi-10.
Abesifazane babuye bazalwa ngokwengeziwe ngokubonakala kwalolu shintsho olwenzeka esikhunjeni, ngokuvamile ezimele:
- uhlobo lomuthi osetshenzisiwe;
- umthamo wayo;
- ubukhulu besifo;
- Izinga lesinxephezelo se-carbohydrate metabolism.
Uhlobo loshintsho lwe-atrophic lubonakala ngokuziphindaphinda (indawo, indawo yomjovo olinganiselwe) ukuguqulwa kwezicubu, noma kubonakaliswa ngokunyamalala okuphelele nokufana ngomfaniswano kongqimba lwamafutha angenasici ngaphansi kobuso bomzimba wonke. Ngokucatshangelwa, ukwenzeka kwabo kuchazwa ngezinga elinganele lokuhlanzwa kwemithi, kanye nokungahambisani nendlela yokujova: ukwethulwa kwekhambi elingashisi, ukungena kotshwala ungene ekujuleni kwesikhumba esilimele.
Uhlobo lwe-hypertrophic (i-lipohypertrophy) lubonakala ngokuvela kweshubhu, okukhombisa ukusuka kungqimba lwesikhumba kufakwa ngaphakathi kukhiqizwa izicubu ze-adipose ezingonakalisiwe ngemisipha yokuhluma kwezicubu ze-fibro-scar (bheka isithombe). Ukubukeka nokwakheka kwalezi zingqungquthela kubangelwa umphumela wokukhetha we-insulin kumandla we-metabolism wezicubu ezikulesi ndawo sendawo esinqunyelwe.
I-lipodystrophy yesithombe ngenxa yomjovo we-insulin:
Ukuba khona kwe-lipodystrophy kusifo sikashukela kungahlanganiswa nezinye izibonakaliso zesikhumba:
- i-xanthomatosis;
- i-lipoid necrobiosis;
- ukukhuluphala kwe-dysplastic.
Izindlela zokwelapha
Ngenxa yokungazi kwazo zonke izizathu zokuthi kungani isimo sokuwohloka kwamafutha sikhona, umthelela ophumelelayo enqubweni yokwenziwa kwawo nokukhula kwawo akunakwenzeka, ngakho-ke, izindlela ezisetshenzisiwe zinikeza umphumela wesikhashana nje.
Phakathi kwazo ukusetshenziswa kwe:
- ukudla
- imfundo yezomzimba;
- amasu we-physiotherapeutic (inductothermy ne-ultrasound).
Umthelela wokungena kwe-ultrasound ekujuleni kwezicubu ngamasentimitha ayi-10, ukuguquguquka kwawo okuvusa ukuhamba kwegazi, kuholela ekuqhekekeni okukhulu kwesakhiwo sokuqongelelwa kwamafutha. Ukusetshenziswa kwayo kuhlangene nokusetshenziswa kwamafutha e-hydrocortisone kunomthelela ekuvuseleleni masisha izindawo ezingatheni. Ukusetshenziswa kwalezi zinyathelo kukuvumela ukuthi unqande ukuqhubeka kwenqubo izinyanga eziyisithupha kuya eminyakeni emibili.
Imizamo yokumisa ukukhula kwe-lipodystrophy ngokumisa ukusetshenziswa kwama-proteinase inhibitors, ukuguqula irejimeni ye-ARVT (i-antiretroviral therapy), kanye nokusetshenziswa kwezindlela zokuhlinzwa ze-liposuction nezindlela zokuhlinza (ukusebenzisa imijovo nokufakwa) kunika umthelela wesikhashana nje.
Izindlela zokuthonya lesi simo ziyahlolwa:
- ama-hormone okukhula komuntu;
- testosterone
- izidakamizwa ezinciphisa ukuqoqwa kwe-triglycerides ne-cholesterol egazini, kanye nokwandisa ukuzwela kwe-insulin.
Ingxenye ebaluleke kakhulu yokwelapha ukwanda kwezinga lomsebenzi womzimba nokudla (ikakhulukazi, ngenqwaba yezakhi ze-fiber ezikuvumela ukuthi ulawule izinga lokumelana ne-insulin, ukwandisa ithoni yomzimba futhi kunciphise ubungozi benhliziyo ne-vascular pathology).
Ukuvimbela Izinkinga
Ngenxa yokuthi ubukhona bokuwohloka kwamafutha kuhlanganisa inkambo yezifo eziholela kubo, uhla oluphelele lwezindlela zokuzivimbela luyadingeka.
Amaphuzu ajwayelekile ahlala enza umsebenzi ofanele womzimba futhi unamathela ekudleni okunconyiwe, kanye nokudla okuqinile kwezidakamizwa ezichazwe ngudokotela wakho ngaphansi kokuqashwa njalo komzimba.
Esimweni semvelaphi yesifo se-insulin, lesi sifo esingaphansi siyelashwa. Kuyadingeka futhi ukulandela ngokuqinile imithetho yemijovo (gwema ukungena otshwala esilondeni sesikhumba), fudumeza umuthi owukulimile ekushiseni komzimba.
Ukusetshenziswa kwezinhlobo ze-insulin ezihlanjululwe kakhulu (i-monocomponent ne-monopic) kanye namalungiselelo we-insulin womuntu futhi kusiza ukugwema izinkinga.
