I-Etiology ne-pathogenesis yesifo sikashukela mellitus 1 no-2

Isifo sikashukela, noma ngabe sinegama, impilo yomuntu ayimnandi. Lo mbono awusha futhi awenzi sengathi ungowangempela.

Ngokuphambene nalokho, ukugula ushukela kwenza ushintsho olunzima nolungahloniphi kuyo yonke indlela yokuphila yesiguli.

Kepha lokhu akusona isizathu sokuphelelwa yithemba. Ingxenye yesithathu yezigidigidi zezakhamuzi zomhlaba ezazi mathupha ngalesi sifo, ngaphandle kokulahlekelwa inhliziyo, ziyasiphikisa. Abakholelwa nje kuphela futhi banethemba, kepha bazimisele futhi ukunqoba lokhu kugula okungenampilo.

Futhi nokho, ake sibheke ukuthi hlobo luni lwesifo lolu - isifo sikashukela.

Izinhlobo Zesifo Soshukela

I-etiology yesifo sikashukela iqondwa kahle futhi, ngokujwayelekile, ingachazwa kanjena. Lapho kuphakama izinkinga ze-pathological nohlelo lwe-endocrine, ngenxa yokuthi amanyikwe eyeka ukuhlanganisa i-insulin, ebhekele ukusetshenziswa kwama-carbohydrate, noma, kunalokho, izicubu aziphenduli "ngosizo" esitho salo, odokotela baphawula ukwenzeka kwalesi sifo esingathi sína.

Ngenxa yalezi zinguquko, ushukela uqala ukunqwabelana egazini, okwandisa "okuqukethwe" ushukela. Ngokushesha ngaphandle kokuwoxeka, kufakwa enye into engathandeki - ukuphuma komzimba. Izicubu azikwazi ukugcina amanzi kumaseli bese izinso zibeka isiraphu yeshukela ngendlela yomchamo ovela emzimbeni. Uxolo, ngokuchazwa kwamahhala kwenqubo - lokhu kungukuqonda okungcono.

By the way, kwaba ngalesisisekelo eChina yasendulo lapho lesi sifo satholakala khona ngokuvumela izintuthwane ukuba ziye kumchamo.

Umfundi ongazi angahle abe nombuzo wemvelo: kungani kuyingozi enkulu ukuthi isifo sikashukela, bathi, kahle, igazi selibe elimnandi, kuthiwani ngalokhu?

Okokuqala, isifo sikashukela siyingozi ngenxa yezinkinga ezisikhathazayo. Kukhona ukulimala kwamehlo, izinso, amathambo kanye nokuhlangana, ubuchopho, ukufa kwezicubu zemikhawulo ephezulu nangaphansi.

Ngezwi - lesi yisitha esibi kakhulu hhayi somuntu kuphela, kodwa esintwini, uma sibuyela kwizibalo futhi.

Umuthi uhlukanisa ushukela ezinhlotsheni ezimbili (izinhlobo):

1. Ukuncika kwe-Insulin - uhlobo 1. Isimo sayo esiyingqayizivele sisekusebenzeni kokuqina kwe-pancreatic, okuthi, ngenxa yesifo sayo, ingakwazi ukukhiqiza i-insulin eyanele yomzimba.
2. Uhlobo olungazimele lwe-insulin-2. Lapha inqubo eguqukayo iyisici - i-hormone (i-insulin) ikhiqizwa ngevolumu eyanele, noma kunjalo, ngenxa yezimo ezithile ze-pathological, izicubu azikwazi ukuphendula ngokwanele kuyo.

Kumele kuqashelwe ukuthi uhlobo lwesibili luvela ku-75% weziguli. Bahlala begula kakhulu abantu asebekhulile nabadala. Uhlobo lokuqala, okuphambene nalokho, aluzibi izingane nobusha.

Izimbangela Zesifo Sikashukela soHlobo 1

Lolu hlobo lwesifo sikashukela, olubizwa nangokuthi yisifo sikashukela sentsha, luyisitha esibi kakhulu sabantu abasha, ngoba isikhathi esiningi sivele ngaphambi kweminyaka yobudala engama-30. I-etiology ne-pathogenesis yohlobo lwesifo sikashukela sokuqala ifundwa ngokuqhubekayo. Abanye ososayensi bezokwelapha bathambekele ekukholweni ukuthi imbangela yalesi sifo ilele kumagciwane avusa ukuvela kwesimungumungwane, irubella, inkukhu, umumbala, ihepatitis kanye negciwane lamathumbu leCoxsackie.

Kwenzekani kulezi zimo emzimbeni?

Izilonda ezingenhla ziyakwazi ukuthinta ama-pancreas nezakhi zalo - β-cell. Ukuyeka kokugcina ukukhiqiza i-insulin enanini elidingekayo ezinqubo ze-metabolic.

Ososayensi bakhomba izizathu ezibaluleke kakhulu zesifo sikashukela ezinganeni:

• ukucindezelwa okushisa isikhathi eside komzimba: ukushisa ngokweqile kanye ne-hypothermia;
• ukuphuza ngokweqile kwamaprotheni;
• ukumisela ifa.

Umbulala ushukela akakhombisi umnyombo wawo "omubi" ngokushesha, kepha ngemuva kokuthi iningi selifile - ama-80% amaseli enza okwenziwe nge-insulin.

Uhlelo lwe-pathogenesis lwesifo sikashukela i-mellitus noma isimo (i-algorithm) sokuthuthuka kwalesi sifo sibonisa iziguli eziningi futhi sithinta ubudlelwano obujwayelekile bomphumela wethonya:

1. Isisusa sofuzo sokuthuthukisa lesi sifo.
2. Ukushaywa kwengqondo ngokwengqondo. Ngaphezu kwalokho, abantu abane-irritility ekhuphukayo bangaba abathumbi balesi sifo ngenxa yesimo esingesihle sansuku zonke endizeni yengqondo.
3. I-insulin inqubo yokuvuvukala yezifunda ze-pancreatic kanye nokuguqulwa kwama-β-cell.
4. Ukuvela kwama-antibodies e-cytotoxic (killer), avimba bese evimba impendulo yemvelo yokuvikela ukuzivikela komzimba, okuphazamisa inqubo yokudla umzimba.
5. I-Necrosis (ukufa) kwama-β-cell kanye nokubonakaliswa kwezimpawu ezicacile zesifo sikashukela.

Ividiyo evela kuDkt Komarovsky:

Izinhlobo Zobungozi Besifo Sikashukela sohlobo 2

Izizathu zokukhula kwesifo sikashukela sohlobo 2, ngokungafani neyokuqala, kungukuncipha noma ukuntuleka kombono yizicubu zamanyikwe kukhiqizwa yi-insulin.

Kalula nje: ngokuqhekeka kashukela egazini, ama-β-cell akhiqiza inani elanele laleli-hormone, noma kunjalo, izitho ezithintekayo enqubo ye-metabolic, ngenxa yezizathu ezahlukahlukene, musa "ukuyibona" ​​futhi ungazizwa.

Lesi simo sibizwa ngokuthi yi-insulin ukumelana noma ukuncipha kwezinzwa.

Umuthi ubheka lezi zimfanelo zokuqala ezingezinhle njengezici zobungozi:

1. Ufuzo. Izibalo "zigcizelela" ukuthi i-10% yabantu abanesifo sikashukela sohlobo 2 kuhlobo lwabo bangaba sengozini yokuphindaphinda inani leziguli.
2. Ukukhuluphala ngokweqile. Lesi mhlawumbe yisizathu esinqumayo esisiza ukuthola lokhu kugula ngesivinini esisheshayo. Yini esingayikholisa? Yonke into ilula kakhulu - ngenxa yobubanzi obukhulu bamafutha, izicubu ziyeke ukumunca i-insulin, ngaphezu kwalokho, 'azikuboni' nakancane!
3. Ukwephulwa kokudla. Le nto "ye-umbilical cord" ihlotshaniswa neyedlule. I-zhor engenakufinyeleleka, enongiwe ngenani elifanele lefulawa, okumnandi, okubabayo nokunempilo okubhemayo, ayigcini nje ngokufaka isandla ekuzuzeni isisindo, kodwa futhi ihlukumeza ngokungenamusa ama-pancreas.
4. Isifo senhliziyo. Izifo ezinjenge-atherosulinosis, umfutho wegazi ophakeme, izifo zenhliziyo ezi-coronary zifaka isandla ekuboneni kwe-insulin ezingeni lamaselula.
5. Ukucindezelwa nokucindezelwa okuphakeme kwenhliziyo yezinzwa. Ngalesi sikhathi, ukukhishwa okunamandla kwama-catecholamines ngesimo se-adrenaline ne-norepinephrine kwenzeka, okuthi, kwandise ushukela wegazi.
6. I-Hypocorticism. Lokhu kungasebenzi okungapheli kwe-adrenal cortex.

I-pathogenesis yohlobo 2 lwesifo sikashukela ingachazwa njengokulandelana kwezinkinga ezi-heterogenible (heterogenible) ezibonakaliswa ngesikhathi senqubo ye-metabolic (metabolic) emzimbeni. Isisekelo, njengoba kugcizelelwe ngaphambili, ukumelana ne-insulin, okungukuthi, ukungabukeki yizicubu ze-insulin ezenzelwe ukusetshenziswa kwe-glucose.

Njengomphumela, ukungalingani okunamandla kubonwa phakathi kokukhululwa (ukukhiqizwa) kwe-insulin nokuqonda kwayo (ukuzwela) yizicubu.

Usebenzisa isibonelo esilula, usebenzisa amagama angenasayensi, okwenzekayo kungachazwa kanjena. Ngenqubo enempilo, ama-pancreas, "ebona" ​​ukuthi kukhona ukwanda koshukela wegazi, kanye nama-β-cell akhiqiza i-insulin bese eyiphonsa egazini. Lokhu kwenzeka ngesikhathi sesigaba sokuqala (esisheshayo).

Lesi sigaba asikho ku-pathology, ngoba i-gland "ayisiboni" isidingo sesizukulwane se-insulin, basho ukuthi kungani, isivele ikhona. Kodwa inkinga ilele ekutheni ukusabela okuhlukile kungenzeki, izinga loshukela alinciphi, ngoba izicubu azixhumeki inqubo yokuhlukanisa.

Isigaba sokuncipha noma 2nd semfihlo sivele sivele njengokuphendula kwe-hyperglycemia. Ngokwe-tonic (njalo) imodi, ukukhiqizwa kwe-insulin kwenzeka, noma kunjalo, naphezu kokungaphezulu kwe-hormone, ukwehla ushukela akwenzeki ngesizathu esaziwayo. Iphinda ingapheli.

Ividiyo evela kuDkt Malysheva:

Izinkinga zokushintshana

Ukucatshangelwa kwe-etiopathogenesis yohlobo 1 nohlobo 2 lwesifo sikashukela, ubudlelwano bomphumela wakho, ngokuqinisekile kuzoholela ekuhlaziyweni kwezinto ezifana nokuphazamiseka kwe-metabolic okuthuthukisa inkambo yesifo.

Kubalulekile ukuqaphela ngokushesha ukuthi ukwephulwa ngokwako akuphathwa ngamaphilisi kuphela. Bazodinga ushintsho kuyo yonke indlela yokuphila: ukondleka, ukucindezela ngokomzimba nangokomzwelo.

Ukudla okunamafutha emzimbeni

Ngokuphikisana nenkolelo ethandwayo mayelana nengozi yamafutha, kubalulekile ukuthi uqaphele ukuthi amafutha angumthombo wamandla emisipha ekhathazekile, izinso nesibindi.

Ekhuluma ngokuvumelana nokushumayeza i-axiom - konke kufanele kube kokulingene, kumele kugcizelelwe ukuthi ukuphambuka emgomeni wenani lamafutha, endaweni eyodwa noma kwenye, kuyalimaza umzimba ngokulinganayo.

Ukuphazamiseka kwesimilo kwama-metabolism wamafutha:

1. Ukukhuluphala ngokweqile. Isimo samafutha anqwabelanayo kwezicubu: kwabesilisa - 20%, kwabesifazane - kufinyelela kuma-30%. Konke okuphakeme yi-pathology. Ukukhuluphala yisango elivulekile lokuthuthuka kwezifo zenhliziyo ezi-coronary, umfutho wegazi ophakeme, isifo sikashukela i-mellitus, isifo sokuqina kwemizwa.
2. I-Cachexia (ukukhathala). Lesi yisimo lapho isisindo samafutha akhona emzimbeni singaphansi kokujwayelekile. Izimbangela zokukhathala zingahluka: kusuka ekudleni okuhlala isikhathi eside kokudla okunama-kilojoule amancane, kuya kuma-pathologies e-hormonal, njengokushoda kwe-glucocorticoids, insulin, somatostatin.
3. I-Dyslipoproteinemia. Lesi sifo sibangelwa ukungalingani engxenyeni ejwayelekile phakathi kwamafutha ahlukahlukene akhona kwiplasma. I-Dyslipoproteinemia iyisakhi esilinganayo sezifo ezifana nesifo senhliziyo, ukuvuvukala kwamanyikwe, isifo sokuqina kwemithambo yegazi.

Isisekelo semetabolism eyisisekelo namandla

Amaprotheni, amafutha, ama-carbohydrate - lolu luhlobo logesi lwenjini yamandla enhlangano. Lapho umzimba udakiwe ngemikhiqizo yokubola ngenxa yama-pathologies ahlukahlukene, kufaka phakathi izifo zezindlala ze-adrenal, amanyikwe kanye ne-yegilo yegilo, ukwephula amandla e-metabolism emzimbeni.

Unganquma kanjani futhi kanjani ukuthi uveze inani elingakanani lezindleko zamandla ezidingekayo ekusekelweni kwempilo yomuntu?

Ososayensi sebethule into enjenge-metabolism eyisisekelo, okuyiyo ekusho kwesilinganiso samandla adingekayo ekusebenzeni okujwayelekile komzimba ngezinqubo ezincane ze-metabolic.

Ngamazwi alula futhi angaqondakali, lokhu kungachazwa kanjena: isayensi ithi umuntu ophilile onesisindo esivamile esinesisindo esingama-70 kg esiswini esingenalutho, endaweni yokulala, onesimo sokuvuselela ngokuphelele sezicubu kanye nokushisa kwegumbi okuyi-18 ° C, kudinga i-1700 kcal / usuku ukugcina yonke imisebenzi ebalulekile .

Uma ukushintshaniswa okuyinhloko kwenziwa ngokuphambuka kwe-± 15%, khona-ke lokhu kucatshangelwa ngaphakathi kwebanga elijwayelekile, ngaphandle kwalokho i-pathology iyatholakala.

I-Pathology evusa ukwanda kwe-basal metabolism:

• i-hyperthyroidism, isifo se-thyroid esingamahlalakhona;
• hyperacaction yezinzwa ezinobubele;
• ukukhiqizwa okwandayo kwe-norepinephrine ne-adrenaline;
• umsebenzi owengeziwe wama-gonads.

Ukwehla kwesilinganiso se-basal metabolic kungahle kudalwe yindlala isikhathi eside, okungahle kudambise ukusebenza kwe-thyroid namanyikwe.

Ukushintshana kwamanzi

Amanzi ayingxenye ebalulekile yesinto eziphilayo. Indima nokubaluleka kwayo njenge "moto" ekahle yezinto eziphilayo nokungaqhamuki, kanye nokuxazululeka okuningana okuphakathi kokunye kanye nokuhlukahluka okuhlukahlukene ezinqubweni ze-metabolic ngeke kweqiswe.

Kepha lapha, sikhuluma ngokulinganisela nokuvumelana, kufanelekile ukugcizelela ukuthi konke okweqile nokushoda kwalo kuyalimaza umzimba ngokulinganayo.

Ngesifo sikashukela, ukuphazamiseka ezinqubweni zokushintshana kwamanzi kungenzeka kokubili endaweni eyodwa nakwelinye uhlangothi:

1. Ukwehla komzimba kwenzeka ngenxa yokuzila ukudla isikhathi eside kanye nokwanda kokulahleka kwamanzi ngenxa yomsebenzi wezinso kushukela.
2. Kwesinye isigameko, lapho izinso zingakwazi ukubhekana nemisebenzi enikezwe zona, kuba nokuqongelela ngokweqile kwamanzi esikhaleni se-interellular nasezindongeni zomzimba. Lesi simo sibizwa nge-hyperosmolar hyperhydration.

Ukubuyisela ibhalansi ye-acid-base, ukuvuselela izinqubo ze-metabolic kanye nokubuyiselwa komhlaba indawo efanelekile, odokotela batusa ukuphuza amanzi amaminerali.

Amanzi amahle kakhulu avela kwimithombo yamaminerali yemvelo:

• Borjomi
• I-Essentuki;
• I-Mirgorod;
• I-Pyatigorsk;
• Istisu;
• Amanzi amaminerali aseBerezovsky.

I-carbohydrate metabolism

Izinhlobo ezivame kakhulu zokuphazamiseka kwe-metabolic yi-hypoglycemia ne-hyperglycemia.

Amagama ama-Consonant anokungafani okuyisisekelo:

1. I-Hypoglycemia Lesi yisimo lapho amazinga kashukela egazi aphansi kakhulu kunokujwayelekile. Imbangela ye-hypoglycemia ingaba ukugaya, ngenxa yokuphazamiseka esakhiweni sokuqhekeka nokutholwa kwama-carbohydrate. Kodwa hhayi lesi sizathu kuphela esingaba. I-Pathology yesibindi, izinso, indlala yegilo, izindlala ze-adrenal, kanye nokudla okuphansi kuma-carbohydrate kungadala ukuhla kweshukela kufinyelele ezingeni elibucayi.
2. I-Hyperglycemia. Lesi simo singukuphikisana ngqo kwalokhu okungenhla lapho izinga ushukela liphakeme kakhulu kunokwejwayelekile. I-Etiology ye-hyperglycemia: ukudla, ingcindezi, isimila se-adrenal cortex, isimila se-adrenal medulla (pheochromocytoma), ukwanda kwe-pathological of the gland yegilo (hyperthyroidism), ukwehluleka kwesibindi.

Izimpawu zokuphazamiseka kwezinqubo ze-carbohydrate kushukela

Ama-carbohydrate ancishisiwe:

• ukunganaki, ukudangala;
• ukwehla kwesisindo okungenampilo;
• ubuthakathaka, isiyezi, ukozela;
• i-ketoacidosis, isimo lapho amaseli adinga khona ushukela kodwa angalitholi ngesizathu esithile.

Inani elikhulayo lama-carbohydrate:

• umfutho wegazi ophakeme;
• ukukhohlisa
• izinkinga ngesistimu yethambo nenhliziyo;
• ukuthuthumela komzimba - ukuthuthumela okusheshayo, okunesigqi somzimba okuhambisana nokungalingani kohlelo lwezinzwa.

Izifo ezibangelwa ukwephulwa kwe-carbohydrate metabolism:

Umuthi osemthethweni uthi uhlobo lwesifo sikashukela sohlobo 1 nohlobo 2 alungelapheki ngokuphelele. Kepha sibonga ukubhekisisa njalo isimo sakhe sempilo, kanye nokusetshenziswa kwezidakamizwa, lesi sifo ekukhuleni kwaso sizokwehla kakhulu kangangokuba kuzovumela isiguli ukuthi singazizwa silinganiselwe ekuboneni kwenjabulo yansuku zonke futhi siphile impilo ephelele.