Ukuhlaziywa kwe-hemoglobin ye-Glycated kudlala indima enkulu ekuhlolweni kwesifo sikashukela. Lolu cwaningo lusiza ukukhomba lesi sifo emabangeni okuqala entuthuko, ukuhlola ubungozi obukhona bezinkinga, ukuvimbela ukwanda ushukela ngokuzayo, ukulungisa ukwelashwa, umsebenzi womzimba kanye nokudla okunempilo. Abesifazane abakhulelwe abane-Type 1 sikashukela mellitus bayadingeka ukuthi baphuze i-insulin ngesikhathi esifanele.
Okuqukethwe yi-athikili
- 1 Yini i-glycated hemoglobin
- 2 Kungani uthathe i-HbA1c
- Izici ezi-3 zokuhlaziywa
- 4 Izinzuzo kanye nokubi ocwaningweni
- 5 Ukwehlukanisa imiphumela
- 5.1 Ukuncipha kwe-HbA1c kuzinga le-glucose egazini
- Amazinga we-Target (ejwayelekile) kashukela
- 6.1 I-hemoglobin ye-glycated ingancishiswa kanjani?
- 7 Imibuzo Ebuzwa Njalo
- Izindlela eziyi-8 zokuzimisela
Yini i-glycated hemoglobin
I-hemoglobin ye-Glycated kwesinye isikhathi itholakala ezincwadini zesayensi nezokwelapha njenge-glycosylated noma njengegama elifushane leHbA1c. Yize kunezinhlobo ezintathu zakhona: i-HbA1a, HbA1b ne-HbA1c, ikakhulukazi eyokugcina inesithakazelo, ngoba yakhiwe ngamanani amakhulu kunayo yonke.
Ngokwami, lesi sikhombisi sazisa ukuthi ingakanani i-glucose esegazini isikhathi eside (kufika ezinyangeni ezi-3). Kubonisa ukuthi mangaki amaphesenti hemoglobin aboshelwa ngokungenakuphikiswa ku-glucose.
Ukuguqula:
- I-Hb - i-hemoglobin ngqo;
- I-A1 ingxenyana yayo;
- c - ukukhipha.
Kungani uthathe i-HbA1c
Ukuhlaziya thumela:
- Abesifazane abakhulelwe ukwembula isifo sikashukela esisebusweni.
- Abesifazane abakhulelwe abaphila nesifo sikashukela sohlobo loku-1 ukuze babone ukwanda kwe-hemoglobin ye-glycated ngesikhathi, okungaqala ukungasebenzi kahle kokubelethana, isisindo esikhulu somntwana, kanye nokuphuphuma kwezisu nokubeletha ngaphambi kwesikhathi.
- Abantu abahlolwa ukubekezelela i-glucose. Lokhu kuyadingeka ukuthola umphumela onembe futhi onemininingwane eminingi.
- Labo asebethole isifo sikashukela ukuhlola i-glycemia yabo isikhathi eside.
Futhi, i-hemoglobin ye-glycated ivumela okokuqala ukuthola ushukela noma ihlole isinxephezelo sayo.
Izici zokuhlaziywa
Ukonakala kweHbA1c ukuthi awudingi ukuyilungiselela. Indaba yocwaningo yigazi, ingathathwa sobabili kusuka kuthambo nangomunwe - kuya ngohlobo lokuhlaziya. Ukuhlaziywa kungenziwa nganoma yisiphi isikhathi sosuku. Uma ushintsho belungekho esiswini esingenalutho, lokhu kufanele kuxwayiswe kusengaphambili.
Izinzuzo nobubi bocwaningo
Indlela ngayinye inezinzuzo nezinzuzo zayo. Inzuzo ebaluleke kakhulu yalokhu kuhlaziywa ukubonwa kwamazinga kashukela ezigulini ezingadli noma ezingazidli izidakamizwa njalo. Abanye abantu bazama ukukhipha udokotela wabo, baqale ukunciphisa ukusetshenziswa kwamaswidi nje isonto ngaphambi kokunikela ngegazi, kepha iqiniso liyavela, ngoba i-hemoglobin ye-glycated ikhombisa inani eliphakeme le-glucose ezinyangeni ezimbalwa ezedlule.
Izinzuzo:
- I-DM itholakala ngisho nasezigabeni zokuqala;
- Ungaqapha ukunamathela ekwelashweni nasekudleni ezinyangeni ezi-3 zokugcina;
- igazi liphuma ngomunwe noma emthanjeni;
- ukuhlaziywa kwenziwa nganoma yisiphi isikhathi sosuku;
- imiphumela ihlola ubungozi obukhona bezinkinga zesifo sikashukela;
- izifo ezithathelwanayo azithinti umphumela.
Okubi kubalwa izindleko zokuhlaziywa. Futhi, akuhambi kahle ukwenza ukuhlaziya kuzo zonke izimo, ngoba imiphumela ingahle ihlanekezelwe. Ucwaningo luveza imiphumela eyiphutha kumacala alandelayo:
- Ukumpontshelwa igazi. Lokhu kukhwabanisa kungaphazamisa ukukhonjwa kwezinga le-HbA1c yangempela, ngoba izinhlaka zomnikeli ziyehluka kulowo zomuntu ofakwe ngegazi lomunye umuntu.
- Ukopha kakhulu.
- Izifo zegazi, ezinjenge-anemia yokuntuleka kwe-iron.
- Kukhishwe ngaphambili ubanzi.
- Izifo zesibindi nezinso.
- Kwehlisiwe amazinga we-thyroid.
Ukuqonda imiphumela
I-laboratories ehlukile ingaba namanani ahlukile wereferensi we-glycated hemoglobin;
| Inani le-HbA1c,% | IGlucose, mmol / L | Isiphetho sokuqala |
| 4 | 3,8 | Lokhu kusho ukuthi ingozi yokuba nesifo sikashukela incane, ngoba i-carbohydrate metabolism ijwayelekile |
| 5,7-6,0 | 6,5-7,0 | Kukhona ubungozi besifo sikashukela. Ngemiphumela enjalo, kufanelekile ukunciphisa okumnandi ekudleni futhi ubhalise kwi-endocrinologist |
| 6,1-6,4 | 7,0-7,8 | Ingozi enkulu yokuba nesifo sikashukela |
| 6.5 nangaphezulu | 7.9 nangaphezulu | Izinkomba ezinjalo, kufanele uthintane nodokotela ngokushesha. Imvamisa, lezi zinombolo zikhombisa ushukela okhona, kepha ukuhlolwa okwengeziwe kuyadingeka ukuqinisekisa ukutholwa. |
Izizathu zokwanda kwe-HbA1c zingaba:
- Isifo sikashukela mellitus siyatholakala.
- Ukwehluleka kwe-carbohydrate metabolism.
- I-Iron defence anemia.
- Ukususa i-spleen esikhathini esedlule esedlule.
- Ubuthi be-Ethanol.
- Ukuxilongwa ngemikhiqizo ye-metabolic ehlala emzimbeni isikhathi eside kunesikhathi esifanele ngenxa yezifo zohlelo lokuchama.
Izimbangela ze-hemoglobin encishisiwe
- I-Hypoglycemia
- Yehlisa impilo yeseli elibomvu elihambisana nezifo zegazi ezingavamile.
- Isimo ngemuva kokuhlupheka ngokweqile kwegazi.
- Isimo ngemuva kokumpontshelwa igazi.
- Ukuphazamiseka kwengqondo pancreatic.
Uma owesifazane okhulelwe eletha ukuhlaziywa, inkomba ingaguqulwa kuso sonke isikhathi sokuzala ingane. Izizathu ze-gxuma kungenzeka ukuthi zibange:
- ukuntuleka kwe-iron anemia kumama okhulelwe;
- izithelo ezinkulu kakhulu;
- umsebenzi wezinso ongonakalisiwe.
Ukuxhomekeka kwe-HbA1c kuzinga le-glucose egazini
| Izinga eliphakathi le-glucose egazini izinyanga ezintathu, mmol / l | Inani le-hemoglobin ye-glycated,% |
| 7,0 | 6 |
| 8,6 | 7 |
| 10,2 | 8 |
| 11,8 | 9 |
| 13,4 | 10 |
| 14,9 | 11 |
| 16,5 | 12 |
Amazinga Target (evamile) sikashukela
"Izinga lethagethi" lisho izinombolo okudingeka uzabalwele ukuze ungazithobi izinkinga ngokuzayo. Uma umuntu onesifo sikashukela enenani le-glycated hemoglobin elingaphansi kwama-7%, lokhu kuyinto evamile. Kepha kuzoba ngcono uma lesi sibalo silwela u-6%, into esemqoka ukuthi imizamo yokunciphisa ingalimazi impilo. Ngokulawulwa kwesifo sikashukela esihle, inani le-HbA1c liyi- 6. 6.5%.
Ungayinciphisa kanjani i-glycated hemoglobin
Ukuze ungavumeli impilo nempilo ihambe, kubalulekile ukuthatha izinyathelo ezanele zokunciphisa i-HbA1c. Ngemuva kwakho konke, uma lokhu kungenziwa, ingozi yezinkinga zesifo sikashukela iyanda.
Izindlela ezi-5 ezisebenzayo zokunciphisa i-HbA1c ngaphandle kokulimala:
- Ungawunaki umuthi. Odokotela abagcini nje ngokubayala, kufanele bathembeke. Ukwelashwa okwanele kwezidakamizwa kuyisihluthulelo sezinkomba ezinhle. Akunconywa ukubuyisela izidakamizwa ngokwazo ngama-analogues ashibhile, noma ngabe kukhona into efanayo esebenzayo.
- Ukudla okufanele. Kuyadingeka ukunciphisa kancane inani lama-carbohydrate asetshenzisiwe futhi wenze izingxenye ezincane, kepha wandise inani lokudla. Umzimba kufanele ungabi nayo indlala futhi ube ekucindezelekeni okungapheli. Ngokubulawa yindlala isikhathi eside, ukudla ngokweqile okuvame kakhulu kwenzeka, okuyisikhathi sokugxuma okubukhali ushukela.
- Umsebenzi womzimba. I-Cardiotraining isebenza kakhulu, lapho uhlelo lwezinhliziyo luqiniswa khona, impilo iyathuthuka futhi amazinga kashukela ancishisiwe. Akufanele ulindele imiphumela esheshayo, ngakho-ke ezemidlalo kufanele zihlanganiswe ngokuvumelanayo kwisigqi esijwayelekile sempilo. Uma kuvinjelwe, ukuhamba amabanga emoyeni omusha nakho kuzosizakala.
- Ukugcina idayari. Kufanele kubhalwe phansi ukusebenza ngokomzimba, ukudla, izinkomba ze-glycemia (ukukalwa nge-glucometer), umthamo wezidakamizwa namagama abo. Ngakho-ke kulula ukubona amaphethini okukhuphuka noma ukuncipha kweglucose yegazi.
- Ukulawulwa njalo koshukela. Abanye abantu, ukuze bonge imali, basebenzise imitha kaningana kunesidingo. Lokhu akufanele. Izilinganiso ezihlala zikhona zisiza ukulungisa umsoco noma umthamo wezidakamizwa ngesikhathi.
Imibuzo Ebuzwa Njalo
Lapho umuntu enikezwa okokuqala inkomba yokuthi enze lokhu kuhlaziya, unemibuzo, izimpendulo zazo okungukuthola kangcono kudokotela. Kepha zingatholakala futhi ku-inthanethi. Nazi ezivame kakhulu:
Kungenzeka yini ukuthi imiphumela ibe yiphutha futhi ngoba yini?
Isici somuntu kumele sibhekwe njalo: amashubhu angahlanganiswa, alahlekile, athunyelwe ekuhlaziyeni okungalungile, njll. Futhi, imiphumela ingahle ihlanekezelwe ngenxa yezizathu ezilandelayo:
- ukuqoqwa okungafanele kwezinto;
- kutholakala ngesikhathi sokulethwa kwegazi (ungawukhathaleli umphumela);
- ukuba khona kwe-carbamylated hemoglobin kubantu abanezinkinga zezinso. Le nhlobo ifana ne-HbA1c, ngoba inecala elifanayo, kwesinye isikhathi lithathwa njenge-glycated, ngenxa yalokho umphumela walokho ku-overestimated.
Ngabe kuphoqelekile ukusebenzisa i-glucometer uma ukuhlaziywa kwe-HbA1c kunikezwa njalo?
Ukuba khona kwe-glucometer yomuntu siqu kuyimpoqo, kufanele kusetshenziswe kaningi njengoba kuchazwe yi-endocrinologist. Ukuhlaziywa kwe-hemoglobin ye-glycated kukhombisa umphumela ophakathi kwezinyanga ezi-3. Kepha angakanani amazinga kashukela ashintshashintshayo usuku lonke - cha.
Ukuhlaziywa kwezindleko ku-HbA1c?
Isifunda ngasinye sinamanani aso. Intengo elinganiselwayo yayo ingama-ruble angama-800-900.
Ngabe imiphumela etholakala emalabhoratri ehlukene izofundiswa okuthile?
Ukuhlaziya akunayo indlela ethile yokuxilonga esetshenziswa yiwo wonke ama-laboratories, ngakho-ke imiphumela ingahluka kancane. Ngaphezu kwalokho, ezindaweni ezihlukile kungavela amanani ahlukile wesethenjwa. Kungcono ukhethe ilabhorethri yesimanje futhi efakazelwe bese uhlaziya lapho njalo.
Ukuthatha kangaki i-hemoglobin ye-glycated
Ochwepheshe besifo sikashukela bayelulekwa ukuthi basebenzise ukuhlaziya kanye njalo ezinyangeni ezi-3, okungukuthi, izikhathi ezi-4 ngonyaka ukubheka ukusebenza kahle kwezidakamizwa, isilinganiso sesinxephezelo se-carbohydrate metabolism futhi baqiniseke ukuthi inkomba isengeni elitshengisiwe.
Kungani le nkathi yesikhathi ikhethiwe? I-hemoglobin ye-Glycated ihlobene ngqo namaseli abomvu egazi, okuphila kwawo kungathi izinsuku eziyi-120, kepha ngezifo ezithile zegazi kungancishiswa.
Uma izinga likashukela selizinzile, ukwelashwa ngezidakamizwa kukhethwe kahle futhi umuntu elandela ukudla, ungathatha isivivinyo kancane - amahlandla ama-2 ngonyaka. Kubantu abaphilile, lolu cwaningo lwenziwa njalo ngeminyaka eyi-1-3 ngentando.
Ngabe i-HbA1C yehlukile emadodeni nakwabesifazane
Umehluko phakathi kwemiphumela yabesifazane nabesilisa incane. Ihluka ngokoqobo nge-0.5%, ehambisana nenani le-hemoglobin ephelele.
Amanani amaphakathi we-HbA1C kubantu bobulili obuhlukile ngokuya ngeminyaka:
| HbA1c,% | ||
| Iminyaka | Abesifazane | Amadoda |
| Ngaphansi kweminyaka engama-29 | 4,6 | 4,6 |
| 30 kuye ku-50 | 5,5 - 7 | 5,5 - 6,4 |
| Bangaphezu kuka-50 | Ngaphansi kuka-7.5 | Ngaphansi kuka-7 |
Izindlela zokunquma
Ukuphela kwendlela eyiqiniso esetshenziswa yiwo wonke umuntu ayiyona. Ukunqunywa kwe-hemoglobin ye-glycated kungenziwa kusetshenziswa:
- i-chromatography ye-liquid;
- immunoturbodimetry;
- i-ion exchange chromatography;
- ukuhlaziywa kwe-nephelometric.
Sengiphetha, singasho ukuthi ukuhlaziya kuyisifundo esidingekayo empilweni yabashukela, ngakho ungabona ukuthi isifo sikashukela sinxephezelwa kahle kanjani nokuthi kukhethwe kanjani ngokwanele izidakamizwa.
