Letsoalo la lefu la tsoekere la Herederal phosphate (vithamine D e hanyetsang, hypophosphatemic, rickets)

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Herederal phosphate lefu la tsoekere ke sehlopha se matla sa maloetse a lefutso a nang le phepo e matla ea phosphates le vithamine D. Hypophosphatemic rickets ke lefu le tšoauoang ke hypophosphatemia, khaello ea khalsiamo e nang le calcium le li-rickets kapa osteomalacia, e sa tsotelleng vithamine D. Matšoao a kenyelletsa bohloko ba masapo, masenke le mathata. kholo. Ts'oaetso e ipapisitse le qeto ea serum phosphate, alkaline phosphatase le maemo a 1,25-dihydroxyvitamin D3. Phekolo e kenyelletsa ho kenella ha phosphates le calcitriol.

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Lisosa le pathogenesis ea lefu la tsoekere

Family hypophosphatemic rickets e fumana lefa ka mofuta o hokahaneng oa X o kopantsoeng. Maemo a li-bracosphatemic rickets tse fumanehang ka linako tse ling ka linako tse ling a amahanngoa le tumello ea benign mesenchymal tumors (oncogenic rickets).

Motheo oa lefu lena ke ho fokotseha ha reabsorption ea phosphates ho proximal tubules, e lebisang ho hypophosphatemia. Bofokoli bona bo hlaha ka lebaka la ho potoloha ha lintho 'me bo amahanngoa le litlolo tsa mantlha tšebetsong ea osteoblast. Ho boetse ho na le ho fokotseha ha motsoako oa ka mpeng oa calcium le phosphate. Ho haelloa ke matla a masapo a masapo ho bohlokoa haholo ka lebaka la phosphate le ho se sebetse hantle ha masapo a mafura ho feta ka lebaka la tekanyo e tlase ea khalsiamo le litekanyetso tse eketsehang tsa lihormone tsa parathyroid ka li-rickets tse nang le calcium. Kaha boemo ba 1,25-dihydroxycholecalciferol (1,25-dihydroxyvitamin D) bo tloaelehile kapa bo fokotsehile hanyane, sekoli sebopeho sa mefuta e mafolofolo ea vithamine D se ka nahanoa, ka tloaelo hypophosphatemia e lokela ho baka keketseho ea tekanyo ea 1,25-dihydroxyvitamin D.

Hypophosphatemic rickets (phosphate lefu la tsoekere) ea hlaha ka lebaka la ho fokotseha ha phosphate reabsorption ho li-proximal tubules. Ts'ebetso ena ea tubular e bonoa e le thoko, mofuta oa lefa o matla, o hokahane le X chromosome. Ntle le moo, lefu la tsoekere la phosphate ke e 'ngoe ea likarolo tsa lefu la Fanconi.

Lefu la tsoekere la paraneoplastic phosphate le bakoa ke tlhahiso ea "cell" ea parathyroid ke lisele tsa tumor.

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Matšoao a lefu la tsoekere la Phosphate

Hypophosphatemic rickets e iponahatsa e le letoto la mathata, ho tloha ho asymptomatic hypophosphatemia ho ea lieha ho holisa 'mele le ho hola hanyane ho fihlela tleliniking ea li-rickets tse matla kapa osteomalacia. Hangata lipontšo tsa bana li fapana kamora hore ba qale ho tsamaea, li ba le methapo e meholo ea O le maoto le masapo a mang a masapo, li-pseudo-fractures, bohloko ba masapo le bolelele bo bokhutšoanyane. Ho hola ha mothapo libakeng tsa sehokelo sa mesifa ho ka fokotsa ho sisinyeha. Ka li-ricoph tsa hypophosphatemic, li-rickets tsa lesapo la mokokotlo kapa lesapo la mokokotlo, bofokoli ba enamel ea meno le spasmophilia, e hlahisoang ka li-rickets tse haelloang ke vithamine D, ha li bonoe hangata.

Bakuli ba lokela ho tseba boemo ba calcium, phosphates, alkaline phosphatase le 1,25-dihydroxyvitamin D le HPT ho serum, hammoho le urine phosphate excretion. Ka li-ricoph tsa hypophosphatemic, boemo ba phosphates bo serum ea mali bo fokotsehile, empa ho pepeseha ha bona ka har'a moroto ho phahame. Mefuta ea calcium ea Serum le PTH e tloaelehile, 'me phofo ea alkaline hangata e phahame. Ka li-rickets tse haelloang ke calcium, hypocalcemia e bonoa, ha ho na hypophosphatemia kapa e bonolo, tlhahiso ea phosphates ka moroto ha e eketsehe.

Hypophosphatemia e se e fumanoe ho sa tsoa hlaha. Ka selemo sa 1-2 sa bophelo, matšoao a lefu lena a hlaha: ho khutla ho honyenyane, bofokoli bo matla ba likarolo tse tlase. Bofokoli ba mesifa bo bobebe kapa ha bo eo. Maoto a makatsang a makatsang a na le tšobotsi. Ho batho ba baholo, osteomalacia ea fetoha butle-butle.

Ho fihla joale, mefuta e 4 ea mathata a futsitsoeng ho li-rickets tsa hypophosphatemic e se e hlalositsoe.

Mofuta oa 1 - hypophosphatemia e amanang le X - li-rickets tse loantšang vithamine D (hypophosphatemic tubulopathy, hypophosphatemia, lefutso la lefutso, lefu la tsoekere la phosphate, lefu la tsoekere la phosphate le lelapa le tsoelang pele, lefu la lipeo tsa lefutso la Albert Blairt) ka lebaka la ho fokotseha ha phosphate reabsorption ho proximal renal tubule mme e bonahatsoa ke hyperphosphaturia, hypophosphatemia le nts'etsopele ea liphetoho tsa mofuta o moholo tse tšoanang le litekanyetso tse tloaelehileng tsa vithamine. D.

Ho nahanoa hore ka li-ricotes tsa hypophosphatemic tse kopantsoeng le X, tsamaiso ea ts'ebetso ea 1-a-hydroxylase e nang le phosphate e senyehile, e bonts'ang sekoli ho motsoako oa vithamine D metabolite 1.25 (OH) 2D3. Khokahano ea l, 25 (OH) 2D3 ho bakuli e fokotsoa ka mokhoa o sa lekanang bakeng sa tekanyo e teng ea hypophosphatemia.

Lefu lena le iponahatsa ho fihlela lilemo tse peli tsa bophelo. Matšoao a tsebahalang haholo:

kholo e makatsang, squat, matla a maholo a mesifa, ha ho na hypoplasia ea enamel ea meno a sa feleng, empa ho na le li-extensions tsa sebaka sa pulp, alopecia,
hypophosphatemia le hyperphosphaturia le calcium e tloaelehileng ea mali le mosebetsi o eketsehileng oa alkaline phosphatase,
ho holofala leoto leoto (ha a qala ho tsamaea),
Liphetoho tsa "X-ray" joalo ka masapo masapong - ho pharalla ho pharaletseng ha mokokotlo, mokhoa o rarahaneng oa trabeculae, osteoporosis, ho fokola ha masapo a tlase, ho lieha ho theha skeleton, botlalo ba khalsiamo e teng skeleton.

Ho kenyelletsoa ha phosphates lipelong ho fokotseha ho fihla ho 20-30% kapa ka tlase ho moo, tlhahiso ea phosphorus ka har'a moroto e eketseha ho isa ho 5 g / ka letsatsi, ts'ebetso ea alphaline phosphatase e eketseha (makhetlo a 2-4 ha e bapisoa le e tloaelehileng). Hyperaminoaciduria le glucosuria ha li sebetse. K'halsiamo ea calcium ha e fetoloe.

Ho na le mefuta e 4 ea kliniki le ea biochemical ea lefu la tsoekere ho ea ka karabelo ea ho hlahisoa ha vithamine D. Karolong ea pele ea pele, keketseho ea litaba tsa "phosphates" e hlophisitsoeng maling nakong ea kalafo e amahanngoa le keketseho ea ho ts'oaroa ha tsona botoneng ba renal tubules, ho ea bobeli, phosphate reabsorption ka liphio le mala e ntlafatsoa. - Reabsorption e eketsehileng e hlaha feela ka mpeng, 'me ea bone, kutloisiso ea vithamine D e eketseha haholo, hoo le hore litekanyetso tse nyane tsa vithamine D li baka matšoao a tahi.

Mofuta oa II - mofuta oa li-hypophosphatemic rickets - ke 'muso o ikemetseng o sa amaneng le lefu la X chromosome. Lefu lena le tšoauoa ka:

ho qala ha lefu lena a le lilemo li 1-2,
maoto a malelele ka ho qala ho tsamaea, empa ntle le ho fetoha bophahamo, mmele o matla, bofokoli ba marapo,
hypophosphatemia le hyperphosphaturia e nang le maemo a tloaelehileng a khalsiamo le keketseho e leka-lekaneng ea ts'ebetso ea alkaline phosphatase,
X-ray: matšoao a bonolo a li-rickets, empa ka osteomalacia e matla.

Ha ho na liphetoho phetohong ea li-electrolyte, CBS, khatello ea lihormone tsa parathyroid, sebopeho sa li-amino acid, boemo ba creatinine le nitrogen e setseng serapeng. Liphetoho tsa moroto ha li senyehe.

Mofuta oa boraro - ho itšetleha ka "autosomal recessive" ho feta ka vithamine D (li-hypocalcemic rickets, osteomalacia, hypophosphatemic vithamine D tse itšetlehileng ka aminoacidia le aminoaciduria). Sesosa sa lefu lena ke tlolo ea sebopeho sa 1.25 (OH) 2D3 lipelong, e lebisang ho kenngoeng ha calcium ka mpeng le phello e tobileng ea vithamine D ho li-receptor tse khethehileng tsa masapo, hypocalcemia, hyperaminoaciduria, sekhahla hyperparathyroidism, phosphorus reabsorption le hypophosphatemia.

Ho qala ha lefu lena ho bolela lilemo tse likhoeli tse tšeletseng. ho fihlela ho lilemo tse 2 Matšoao a tsebahalang haholo:

thabo, ho ferekana, ho tsitsipana,
hypocalcemia, hypophosphatemia, hyperphosphaturia le ts'ebetso e eketsehileng ea alphaline phosphatase maling. E eketsoa ke li-hormone tsa plasma parathyroid, mme li-aminoaciduria tse akaretsang le sekoli li boetse li bonoa, ka linako tse ling e le lekoala la ho ntša metsi ka moroto,
ho lieha ho qala ho tsamaea, ho ts'oha, ho holofala ho hoholo ka potlako, bofokoli ba mesifa, hypelopelia ea enamel, litlolo tsa meno,
X-ray e ile ea senola li-rickets tse matla libakeng tsa kholo ea masapo a malelele a tubular, tšesaane ea mokokotlo oa cortical, tšekamelo ea lefu la ho fokola ha masapo. Ha ho na phetoho ho CBS, litaba tsa naetrojene e setseng, empa khatello ea l, 25 (OH) 2D3 maling e fokotsehile haholo.

Mofuta oa IV - khaello ea vithamine D3 - o futsoa ka tsela e amohelang maikutlo kapa ea hlaha ka nako, banana ba kula haholo. Ho qala ha lefu lena ho bonoa bongoaneng, ho bontšoa ke:

maoto le matsoho, deformation ea skeleton, cramp,
khafetsa alopecia 'me ka linako tse ling meno anomatic,
X-ray e senotse li-rickets tsa maemo a fapaneng.

Tlhahlobo ea lefu la tsoekere

E 'ngoe ea matšoao a belaellang lefu la tsoekere la phosphate ke ho se sebetse ha litekanyetso tse tloaelehileng tsa vithamine D (2000-5000 IU / letsatsi) ho ngoana ea nang le li-rickets. Leha ho le joalo, poleloana e reng "vithamine D e loantšang", eo pele e neng e sebelisetsoa lefu la tsoekere, ha e ea nepahala.

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Tlhahlobo e fapaneng ea lefu la tsoekere la phosphate

Hoa hlokahala ho khetholla lefu la tsoekere la lefutso le li-rickets tse haelloang ke vithamine D, e iphumaneleng kalafo e rarahaneng, de Toni-Debre-Fanconi syndrome, lefu la masapo le sa foleng le sa foleng.

Ha matšoao a lefu la tsoekere a phosphate a etsahala ka lekhetlo la pele ho motho e moholo, oncogenic hypophosphatemic osteomalacia e lokela ho nahanoa. Phapang ena ea paraneoplastic syndrome e bonoa metsong e mengata, ho kenyelletsa le letlalo (dysplastic nevi).

Lefu la tsoekere ke phosphate

Lefu la tsoekere la phosphate ke lebitso le tloaelehileng bakeng sa mafu a tlhaho, litšobotsi tsa ona ke:

ho haella ha phosphorus 'meleng,
kholo ea lefu la masapo,
ponahalo ea matšoao a kang a rickets.

Lefu la tsoekere la phosphate ke bokuli bo sa tloaelehang haholo bo nang le monyetla oa 1: 20,000 oa ho bo holisa.

Hoo e ka bang mefuta e robeli ea pathology e khetholloa ho latela phetoho ea mofuta o itseng oa lefutso. E atileng ka ho fetisisa ke li-rickets tsa "hypophosphatemic" tse amanang le X ka lebaka la ho phatloha ha mofuta oa REX.

Ho latela lipatlisiso tsa morao-rao tsa bongaka, lintho tse futsitsoeng tsa motho li kenyeletsa mefuta e fetang likete tse 28.

Lefu la tsoekere la phosphate ke lefu le amanang le tlhaho;

Hobaneng ha lethathamong la phosphorus 'meleng le fokotseha nakong ea bokuli?

"Ho phatloha" hoa liphatsa tsa lefutso ho lebisa ho sitisong ea phosphorous phosphorous liphoofong tsa renal. Mali a kena ka har'a mouoane oa letsoana 'me a etsa lintho tse tlhotliloeng. Ka lebaka leo, ho tsoa moroto oa mantlha le oa bobeli. Motsoako oa mantlha o kenyelletsa lintho tse hlokahalang bakeng sa 'mele: tsoekere, protheine, sodium, phosphorus, calcium. Likarolo tsena tse molemo tse tsoang metsong ea makhopho li kenella maling. Ts'ebetso e joalo e bitsoa "reabsorption".

Metsong ea liphio, ho nchafatsa lintho tse nang le molemo 'meleng hoa etsahala

Lintho tse sa hlokahaleng (li-toxin, chefo) li nkuoa ho tsoa leseeng ka moroto oa bobeli: moroto o kena ka hare ho senya, senya le ho tsoa 'meleng ka har'a urethra. Ho lefu la tsoekere la phosphate, phosphorus ha e kenngoe maling ho tsoa lipelong, empa e hloekisoa ka ts'ebetso ea moroto. Khaello ea ntho ena e thehoa 'meleng, e isang timetsong ea lithane tsa masapo, atrophy ea mesifa, le ho hlaha hoa maloetse a bohloko ba methapo le methapo.

Phosphorus e ikarabella bakeng sa boemo ba masapo a batho, hape e ama ts'ebetso ea pelo le liphio.

Mathata a mang a metabolic ho lefu la tsoekere la phosphate

Hape, ka lefu lena, ho ka bonoa lits'ebetso tse ling tse mpe 'meleng:

ts'ebetso e sa sebetseng ea hormone ea parathyroid (parathyroid hormone), e laolang metabolism ea calcium-phosphorus. Ka lebaka leo, calcium reabsorption le eona ea fokotseha.
tlolo ea sebopeho 'meleng oa vithamine D, e kopantsoeng letlalong ka tlasa tšusumetso ea mahlaseli a kotsi a letsatsi, hape e kena' meleng ka lijo. Le ha ho le joalo, vithamine D e ka fetoha mafolofolo ka mor'a ts'ebetso e 'ngoe e hlahang ka har'a li-renal tubules. Ka lefu la tsoekere la phosphate, lits'ebetso tsena lia senyeha, ka hona khaello ea vithamine D e hlaha 'meleng.

Matšoao a pathology

Lefu lena le iponahatsa ho bana ba seng ba le lilemo li 1-2 mme e tsamaisana le matšoao a latelang:

sefuba sa sefuba
protrusion ea tubercles tsa ka pele,
Sebopeho sa maoto a kang "Wheel-wheel",

Ka lefu la tsoekere la phosphate, maoto a ngoana a bonoa lengolo "o"

Haeba kalafo ea lefu lena e sa qala bongoaneng, joale matšoao a lefu la tsoekere a phosphate a bonoa ho bakuli ba baholo:

bohloko bo boholo manonyeletsong a likarolo tse tlaase, matsoho, morao,
ho satalla ha metsamao. Ho thata hore monna a tsamaee, squat, a khumame,
khafetsa khafetsa ea maoto le matsoho e bang teng ka lebaka la tšenyo ea masapo,
ho tsoa mali
ho ba sieo ha meno kapa ho hloka meno ka botlalo,
tahlehelo ya kutlo
kizungubetso le ho akheha, ho etsahala khahlano le semelo sa atrophy ea lijana tsa lesapo la mokokotlo.

Tšebeliso ea meriana

Ho lefu la tsoekere la phosphate, ho fanoa ka litlhare tse latelang:

litokisetso tsa phosphorus. Ho amohela ho etsoa ka makhetlo a 4-6 ka letsatsi. Litekanyetso tsa meriana li latela lilemo tsa mokuli mme li khethoa ke ngaka e eang. Phekolo ea bana ba banyenyane, lithethefatsi li ka tsoakoa le motsoako oa lebese, litholoana le purees ea meroho, lino,
Alfacacidol ke analogue ea vithamine D. Moriana ha o fetole metabolism ea phosphorus le calcium feela, empa hape e thusa ho fokotsa bohloko, o ntlafatsa ts'ebetso ea ho sisinyeha. Regimen ea kalafo e ipapisitse le boemo ba PTH,

Alfacacidol - analogue ea vithamine D

Phekolo ea kalafo

Phekolo ea kalafo ea lefu la tsoekere ea phosphate e bontšoa maemong a joalo:

ka bolelele bo fapaneng ba maoto. Ketsahalo ena e etsahala ha leoto le leng le tlase le entse tlokotsi e kholo ho feta e 'ngoe.
ka phetoho e kholo sebopeho sa mangole, maqaqaqaqailana kapa metheo ea thekeng. Mathata a joalo a ateloa ke ho ba motho ea moholo ea nang le lefu la tsoekere le phosphate. Phetoho e kopaneng ha e lumelle motho hore a tsamaee ka tsela e tloaelehileng mme e ka lebisa ho holofala.

Mefuta ea phekolo ea ho buoa:

epiphysiodeis ea nakoana. E etsoa ka bolelele bo fapaneng ba maoto a bana ba ka tlase ho lilemo tse 15. Lekhetlong lena, motho o mokhatlong oa kholo, kahoo ka thuso ea lisebelisoa tsa bongaka, o ka fetola keketseho ea bolelele ba maoto le matsoho. Leotong, e hlokang ho khutsufatsoa, ho kentsoe lipente tse 8 tse bopehileng joaloka sebopeho. Lisebelisoa li ikemiselitse ho maoto le matsoho holimo le ka tlase ho libaka tsa kholo. Libaka tse hloahloa ka maoto le mapheong a ka holimo le tlaase, hammoho le leotong le tlase.
tokiso ea masapo. Nakong ea ts'ebetso, masapo a senyehileng a robeha. Ka mor'a moo, lenonyeletso le fuoa sebopeho se nepahetseng, se behiloeng ka lipolanete le likharafu,
kopantswe hammoho. Nakong ea ts'ebetso, ho ba le ts'ebetso e nyane sebakeng sa karolo e kopaneng. Lenonyeletso le senyehileng le nkeloa sebaka ke lera, leqeba le sutumetsoa.

Haeba mokuli ea nang le lengole la phosphate a khumama a hloleha, joale e nkeloa sebaka ke lefutso

Mokhoa oa ho qoba mafu a molomo

Bakuli ba nang le lefu la tsoekere la phosphate ba na le kotsi e eketsehileng ea ho ba le mafu a molomo. Ho qoba ho senya meno le marenene, ho lokela ho lateloa melao e latelang:

hlatsoa meno ka makhetlo a 2-3 ka letsatsi. Tabeng ena, sebelisa borashe ka bristles e bonolo,
Kamora sejo se seng le se seng, hlatsoa lesapo la molomo ka tharollo ea antiseptic,
qoba ts'ebeliso ea lipompong (liswiti, tsoekere, likuku, marmalade),
etela ngaka ea meno bonyane nako e le 'ngoe ka khoeli,
sireletsa bokantle ba meno ka ho koala enamel ka polasetiki e khethehileng ea gel. Tsamaiso e joalo ea thibelo e etsoa ofising efe kapa efe ea meno.

Lefu la tsoekere la bana ho bana: lisosa, matšoao, melaoana ea kalafo

Poleloana “lefu la tsoekere la phosphate” e kopanya sehlopha sa maloetse a amanang le lefutso, a ipapisitseng le tlolo ea ho tsamaisoa ha phosphates ka har'a li-proximal tubules tsa nephron, ho kenella ha tsona ka ka mala, ka lebaka leo, khaello ea letsoai la phosphoric acid. Ho boetse ho na le mabitso a mang bakeng sa psychology ena. Ka lebaka la tekanyo e tlase ea metsoako ea phosphorus maling le setšoantšo sa ramatiki, e boetse e bitsoa li-hypophosphatemic rickets, 'me ho nahanela maikutlo a fokolang a kalafo ka vithamini D, e bitsoa li-rickets tse nang le vithamine D.

Psychology ena ke bothata bo tloaelehileng ba tleliniki ho methapo ea bana kapa nephrology. Bohlokoa ba eona bo bakoa ke tlhoko ea kalafo ea nako e telele, ka linako tse ling ea bophelo, ho se khonehe ha mekhoa ea kalafo ea hajoale ho felisa ka botlalo lipontšo tsa lefu lena le bofokoli ba masapo.

Litlhaloso tsa pele tsa lefu lena li hlahile lekholong la bo20 la lilemo. Mokuli o ne a ngolisitsoe ka mofuta o atileng haholo oa li-hypophosphatemic rickets mme karolo ea lefutso ho hlaha hoa eona e netefalitsoe. Hamorao, mefuta e meng ea lefu la tsoekere la phosphate le eona e ile ea tsebahala, e na le likarolo tse tloaelehileng le lisosa tsa eona, mofuta oa lefa le likarolo tsa thupelo. Ka tlase re lula ho tse kholo.

Thupelo ea bongaka ea lefu la tsoekere ea phosphate ke polymorphic. Hangata lefu lena le qala ho hlaha bongoaneng, empa le ka iponahatsa hamorao - ka lilemo tse 7-9. Ntle le moo, ho teba ha matšoao a hore na ho kula ho ka ba ho fapaneng le eng. Maemong a mang, lefu lena le na le mofuta oa lona 'me le bonahala ka liphetoho tse bonolo ho metabolite ea phosphorus. Leha ho le joalo, li-rickets tsa hypophosphatemic khafetsa li na le setšoantšo se pepesitsoeng sa kliniki:

ho khutla ha kholo ea 'mele le sekhahla sa kholo,
lesapo le senyehileng (lesapo la mokokotlo la likarolo tse ka tlase, "li-rickets" likhopo, letheba la masapo a sephara a sephakeng, ho senyeha ha lehata),
Phetoho ka sejoana sa masea (se tšoana le letata)
tlolo ea sebopeho sa meno,
ologicalological
bohloko ba masapo, jj.

Ho fokolisa mesifa, tšobotsi ea li-rickets tsa 'nete, hangata ha ho na lefu la tsoekere.

Nts'etsopele ea kelello boteng bona ha e utloe bohloko.

Ho khetholla lefu la tsoekere la phosphate ho bana ho ipapisitse le setšoantšo se tloaelehileng sa kliniki, data e tsoang tlhahlobong le tlhahlobo ea 'mele. Tlhahlobo eo e netefalitsoe ke liphetho tsa lithuto tsa mahlale le tsa bongaka:

liphetoho litekong tsa mali (hypophosphatemia, phosphatase e eketsehileng ea alkaline, maemo a tloaelehileng kapa a phahametseng a hormone ea parathyroid le calcitonin) le moroto (hyperphosphaturia, ho fokotsa phosphate reabsorption ka li-renal tubules, ho eketsa khalsiamo ea calcium feela ka li-hypophosphatemic rickets tse nang le calcuria),
Lintlha tsa X-ray (matšoao a icoporosis ea methapo, bofokoli ba masapo, liphetoho sebopeho sa masapo, osteomalacia).

Ka nako e 'ngoe ha lefu lena le qala, bakuli ba joalo ba fumanoa ba na le li-rats mme kalafo e beoa le vithamini D, kalafo e joalo ha e fane ka litholoana mme e fana ka lebaka la ho belaela lefu la tsoekere ho ngoana. Haeba ho hlokahala, maemong a joalo, thuto ea liphatsa tsa lefutso e ka abeloa ho khetholla bofokoli ba liphatsa tsa lefutso.

Ho kopantsoe ha hypophosphatemia le li-rickets tsa maoto le matsoho ho boetse ho bonoa maemong a mang a pathological ao ho a khetholloang khethollo e lokelang ho etsoa:

lefu la liphio (renal tubular acidosis, lefu le sa foleng la liphio) le sebete (cirrhosis),
endocrine patology (hyperfunction ea parathyroid gust),
malabsorption ho ulcerative colitis, celiac Enteropathy,
alimentary (lijo) khaello ea vithamine D le phosphorous,
ho nwa meriana e itseng.

Phekolo e phethahetseng ea li-hypophosphatemic rickets e lokela ho qala methating ea pele ea lefu lena. Pele ho tsohle, e etselitsoe ho lokisoa ha mathata a metabolic le thibelo ea bofokoli ba masapo. Ha ho laetsoe, ts'ebetso ea ts'ebetso le mamello ea motho ka mong ea meriana e tsotelloa.

Motheo oa phello ea kalafo ke kalafo ea nako e telele e nang le litekanyetso tse phahameng tsa vithamine D. E ngotsoe:

ka litlolo tse mafolofolo liseleng tsa masapo,
tahlehelo ea methapo ea phosphorus ka har'a moroto,
litekanyetso tse eketsehileng tsa alkaline phosphatase maling,
sethaleng sa ho itukisetsa ho buuoa ho lokisa bofokoli ba marapo.

Litekanyetso tsa pele tsa vithamini D ke 10,000-20000 IU ka letsatsi. Keketseho ea bona e eketsehileng e etsoa tlasa taolo ea matšoao a metabolism ea phosphorus-calcium maling. Litekanyetso tse phahameng tsa letsatsi le letsatsi li ka ba ngata haholo 'me ka linako tse ling li fihla ho 250,000-300,000 IU.

Ha ho e-na le mamello ea motho ka mong ea vithamine D, hammoho le hypercalciuria e matla, ho khethoa ha kalafo e joalo ho nkuoa ho sa lokelang.

Ntle le vithamine D, bakuli ba joalo ba khothalletsoa ho nka:

phosphorus le calcium litokisetso,
motsoako oa citrate (nakong ea likhoeli tse 6 ho ntlafatsa ho monya lintho tsena tsa ho batla),
kholo ea lihormone.

Nakong ea ts'ebetso e phahameng ea ts'ebetso, bakuli ba eletsoa hore ba phomole betheng, kamora ho fihlela phallo - ho silila ka kalafo, ho ikoetlisa ka ho ikoetlisa le ho phekola spa.

Litekanyetso tsa katleho ea kalafo e bolokehileng ke:

bophelo bo botle,
ho potlakisa kholo,
normalization of phosphorus metabolism 'meleng,
matla a radiology (ho khutlisetsoa sebopeho se tloaelehileng sa masapo).

Boteng ba bofokoli bo phatlalalitsoeng ba masapo khahlanong le semelo sa phetoho ea tleliniki le ea laboratori, khalemelo ea bona ea ts'ebetso e etsoa. Mekhoa e latelang e ka sebelisoa bakeng sa sena:

osteotomy (masapo) a masapo a malelele a tubular ka tokiso ea lengole la maoto le matsoho.
litho tsa maoto le matsoho ke ho sitisoa ke lisebelisoa tsa Ilizarov le compression.

Ts'ebetso e joalo e lokela ho etsoa feela kamora kalafo ea nako e telele ea ho boloka matla le ho hlahloba hantle.

Haeba lefu la tsoekere la phosphate le belaelloa, ho hlokahala hore u ee ngakeng ea bana eo ka mor'a tlhahlobo ea pele, e tla fetisetsa ngoana ho ea buisana le ngaka ea methapo ea kutlo, orthopedist, le nephrologist. Phekolo e kenyelletsa masseur, physiotherapist, setsebi ho tsa kalafo ea boikoetliso le phepo e nepahetseng. Haeba ho hlokahala, kalafo e etsoa ke ngaka e buoang ea methapo.

Ka ho fumana kalafo ka nako le kalafo ea pele, lefu la tsoekere la phosphate le loketse. Leha ho le joalo, bakuli ba bang ba hloka kalafo ea bophelo bohle ka tlhahlobo ea vithamine D. Ho lieha ho tseba hore na lefu la tsoekere le mpefala ho feta, hobane bofokoli ba masapo bo fokotsa boleng ba bophelo ba bakuli.

Lefu la tsoekere la bana ho bana: lefu le iponahatsa, kalafo le foto

Ho thehoa ha lefu la tsoekere la phosphate ha ho amane le tšenyo ea manyeme le ho eketseha ha tsoekere ea mali.

Lefu lena, joalo ka lefu la tsoekere, le na le tšoaetso ea lefutso. Matšoao a eona a hlahisoa ke 'nete ea hore phosphorus ha e kenngoe maling ka methapong ea kutlo.

'Meleng, khatello ea mali ea eona ea fokotseha, sebopeho sa lisele tsa masapo se senyehile, e leng se lebisang bofokoling sebopeng sa skeleton le anomalies ka sebopeho sa' mele.

Ho ipapisitse le lisosa tsa phosphate, lefu la tsoekere le ka khethoa ka liphatsa tsa lefutso ho tloha ho batsoali ba kulang ho ea ho bana kapa ea ba pontšo ea li-benign tumors (oncogenic rickets).

Hypophosphatemic rickets e etsahala ka ho fokotsoa ho kenngoa ha phosphorous ho tsoa ho moroto oa mantlha, hammoho le ho kenella kahare ho calcium le phosphates ho tsoa ka popelong, ho fokotseha ha sebopeho sa vithamine D le ts'ebetso ea eona ka har'a sebete. Ho fokotseha ha tšebetso ea lisele tse bōpang lithane tsa masapo (osteoblasts) ho lebisa tlhokomelong ea hore masapo a na le sebopeho se senyehileng.

Bana baa kula ha ho e-na le lefu le tšoanang la batsoali ho batsoali ba bona. Ha ho na mekhoa e khethehileng ea thibelo ea lefu lena. Haeba ntate a kula, o fetisetsa lefu la tsoekere ho morali oa hae, 'me bara le bara le barali ba nang le bothata bo joalo ba tsoalo ba ka tsoaloa ke bo-mme ba kulang. Mofuta o ikarabellang bakeng sa tšebetso ea osteoblasts le lethathamo la phosphorus maling le hokahane le X chromosome.

Ho hoholo ka ho fetesisa, bashanyana ba na le li-rickets tsa hypophosphatemic. Botsofaling, lefu lena le ka amahanngoa le hlahala lesapong kapa lithong tse bonolo.

Ka lefu la tsoekere la phosphate, mathata a joalo a ba teng:

Kholo ea masapo
Ho nolofatsa masapo
Phetoho ea manonyeletso a mangole le mangole
Keketseho e potlakileng ea ho holofala leoto le tlase.

Hypophosphatemic rickets e ka qala o sa le monyane haholo, hangata ka nako eo ngoana a qalang ho itsamaela ka boyona. Pele ho sena, boemo ka kakaretso bo ka lula bo tloaelehile mme ha bo bake ho belaela ho lingaka.

Matšoao a pele ke a makatsang a ngoana, ebe bohloko ba masapo ha a tsamaea. Bana ba ka hana ho potoloha ntle le thuso. Nakong e tlang, maoto a khumama mme sebopeho sa manonyeletso a mangole le maqaqailana sea khathatseha, mme masapo sebakeng sa letsoho a boreleli.

Lipontšo tse joalo li tsamaisana le tlolo ea botsepehi ba enamel ea meno le nts'etsopele ea li-caries tse ngata, mokokotlo oa lesapo la mokokotlo le masapo a pelvic.

Matšoao a tšoaetso ea lefu la tsoekere la Fofat ke:

Molumo o theohile oa mesifa.
Spasmophilia.
Mokokotlo o nang le sebopeho sa maoto.
Pseudo-fractures le bofokoli ba masapo.
Ho khutsufatsa ha maoto le matsoho khafetsa ha ho arabeloe

Tlhahlobo ea X-ray e senotse diaphysis tse ngata (karolo e bohareng ea lesapo la mokokotlo), masapo a masapo a masapo, osteoporosis, sebopeho sa masapo a butle, masapo a na le calcium e ngata.

Tšobotsi e khethollang ea ho hlaka ke ho haella ha karabelo ho ho nka tekanyetso e tloaelehileng ea vithamine D, ho fapana le li-roskare tse tloaelehileng, ka lefu la tsoekere la phosphate, ts'ebeliso ea lona ha e fokotse matšoao a lefu lena.

Hape, ha ho etsoa tlhahlobo ea bongaka, ho fumanoa ha phosphates ka moriring ho phahame ho feta boleng bo tloaelehileng.

Teko ea mali e senola lethathamo le tlase la phosphorus. Ho kenyelletsa mafu a gathy ea parathyroid, boemo ba hormone ea parathyroid boa hlahlojoa. Ka lefu la tsoekere la phosphate, le phahame kapa le ka har'a meeli e tloaelehileng. Mehlala ka ho hlahisoa ha hormone ea parathyroid e bonts'a kutloisiso e fokotsehileng ea li-renal tubules ho eona.

Ntle le moo, ho bakuli, ka linako tse ling mosebetsi o eketsehileng oa alkaline phosphatase le calcium e tlase maling li ka fumanoa haeba kalafo e nang le tekanyetso e phahameng ea phosphorous e boletsoe.

Lefu la tsoekere la bana ho bana le phekoloa ka letsoai la phosphoric acid le calcium ka tekanyo ea 10 mg ea phosphate ka kilo e le 'ngoe ea boima ba ngoana makhetlo a 4 ka letsatsi. Lithethefatsi li nkuoa ka tsela ea tharollo kapa matlapa.

Ho thibela litlolo tsa metabolism ea khalsiamo, ho laetsoe Vitamin D. E sebelisoa ho qala ka tekanyetso ea 0,005 μg mme e eketseha ho fihla ho 0.03 μg ka kilo e le 'ngoe ea boima ba' mele. Ka nako e ts'oanang, boemo ba phosphorus maling bo nyoloha, mme ts'ebetso ea alkaline phosphatase ea fokotseha.

Ho thibela ho hlahisoa ha letsoai la calcium ka mokhoa oa majoe a liphio, boemo ba calcium bo maling le moroto bo laoloa. Ka boleng bo tloaelehileng, butle-butle u ka eketsa tekanyetso ea vithamine D.

Hape, bakuli ba joalo ba bontšoa ho khethoa ha litokisetso tsa calcium. Ho ntlafatsa ho kenella ha letsoai la phosphorous le calcium ho tloha ka sebopeho sa mala ho kopantsoe le asiti ea citric. Etsa kopo ea Calcium Gluconate, Fitin, Calcium Glycerophosphate, Sodium Citrate. Phekolo e etsoa nako e telele - ho isa ho likhoeli tse tšeletseng.

Ntle le moo, mefuta e latelang ea kalafo e fuoe bakuli:

Phekolo ea Vitamin e nang le tocopherol (vithamine E) le vithamini A.
Khetho ea corset ea orthopedic bakeng sa tokiso ea mokokotlo oa mokokotlo oa hau.
Qetellong ea kholo, kalafo ea ho buoa e ka etsoa ka bohlokoa ba deformation ea masapo.
Ka lefu la tsoekere la oncogenic phosphate, hlahala ea tlosoa.

Boemong ba mafolofolo ba lefu lena le bohloko bo boholo masapong, lesapo la mokokotlo le manonyeletso, bakuli ba fuoa phomolo ea bethe. Hangata nako ea eona e ka ba matsatsi a 15. Ho khothalletsoa tšebeliso ea li-painkiller le litlhare tse seng khahlanong le ho ruruha tse seng tsa steroid.

Ha lefu lena le se le fetile molemong oa ho ikatela ha bongaka le kalafo, bakuli ba fuoe ts'ebetso ea ho boloka mmele ka thibelo ea ho tlola le ho ikoetlisa ka matla.

Ho khothalletsoa ho etsa mokhoa oa ho silila ka kalafo, libate tsa letsoai le li-whirlpool, kalafo maemong a sanatorium.

Mefuta e mene ea maloetse e khetholoha ho latela mofuta oa tšitiso ea metabolic. Mefuta e 'meli ea pele ea lefu lena e monate (mabapi le kholo ea nako e telele). Khetho ea pele e hlaha selemong sa pele sa bophelo, bofokoli bo fokolang ba masapo, vithamini D e mamelloa hantle. E kopantsoe le tlhahiso ea phosphorus le calcium ka moroto le makhopho.

Karolong ea bobeli ea lefu lena, lefu lena le hlaha selemong sa bobeli sa bophelo, ho thoe liphetoho tsa masapo, phosphorous maling e theotsoe, phosphorus e ngata e ntšoa ka har'a moroto. Vitamin D e bontša ho hanyetsa. Tahlehelo ea phosphorus e amana ho tloha ha ts'abo ea menoana e senyeha ka lefu la tsoekere. Kholo ea bana e fokotsehile hanyane, 'mele o matla. Matšoao a X-ray a li-rickets, ho nolofatsa ha masapo.

Khetho ea boraro e qala ha a le lilemo li hlano, masapo a senyehile haholo, calcium e maling e ea fokotseha, 'me calcium le phosphates ha li kenngoe ka mpeng. Vitamin D e bontšitse ho hanyetsa.

Bana ba ferekane, meno a na le bofokoli enamel, tloaelo ea ho ts'oasa. Tekanyo ea calcium calcium e theotsoe, 'me li-amino acid tse ngata li qheletsoe ka har'a moroto. Ho na le matšoao a tšoaetso ea bobeli ea litsoelesa tsa parathyroid. Tlhahlobo ea X-ray e senola liphetoho sebakeng sa kholo ea masapo, osteoporosis.

Khetho ea bone e bontšoa ke ho eketseha ha kutloisiso ea vithamine D le tšekamelo ea hypervitaminosis, leha e sebelisoa litekanyetso tse nyane. Ho qala bongoaneng, ho pepesetsoa maoto le matsoho, ho kuta le ho fifala ha meno.

Mathata a lefu la tsoekere a phosphate a kenyelletsa:

Tlokotsi ea boemo ba maemo le liphokoletso tsa likarolo tse tlase.
Ho khutlisetsoa 'meleng le ka linako tse ling kelellong.
Ho etsoa le meno le meno lia senyeha.
Ho hlahisoa ha calcium ho liphio.
Mathata a ho tsamaisa (karolo ea Caesarean ea hlokahala).

Ho thibela lefu lena ho na le tlhahlobo ea lefutso sethaleng sa kemolo ea kemaro, haholo haeba ho na le maemo a tlhekefetso e joalo ea lefutso ka lapeng kapa ho beng ka motho ea haufi. Litsi tsa tlhabollo ea lefutso li ka hlahisa kotsi ea ho ja lefu la tsoekere.

Haeba ngoana a le kotsing, joale o hlahlojoa ho tloha tsoalong, a hlahloba boemo ba phosphorus le calcium maling le moroto, hape a lekola sebopeho sa skeleton, ho latela kholo ea maemo, lekola karabelo molemong oa ts'ebetso ea thibelo ea vithamine D. Boteng ba matšoao a pele a lefu lena. kalafo ea vithamine. Batsoali ba boetse ba lokela ho etsa kopo bakeng sa melemo ho ngoana ea nang le lefu la tsoekere mme ba fuoe meriana ea mahala le maeto ho ea setsing sa bophelo bo botle.

Ka video e sehloohong sena, Dr. Komarovsky o bua ka khaello ea vithamine D.

Lefu la tsoekere la phosphate: likarolo tsa lefu lena le mekhoa ea kalafo

Lefu la tsoekere la phosphate ke lefu le futsitsoeng le sa amaneng le lefu la tsoekere. Pathology e thehoa ka lebaka la mathata a tlhaho a tlhaho 'me ea iponahatsa e sa le ngoana. Bakeng sa ho hlokomela matšoao a pele a ho kula ho teng ka nako mme o qala ho nka bohato bo hlokahalang, ho a hlokahala hore o be le leseli la matšoao a lefu la tsoekere le phosphate, hammoho le mekhoa ea ho hlahloba le ho phekola.

Lefu la tsoekere la phosphate ke lebitso le tloaelehileng bakeng sa mafu a tlhaho, litšobotsi tsa ona ke:

ho haella ha phosphorus 'meleng,
kholo ea lefu la masapo,
ponahalo ea matšoao a kang a rickets.

Lefu la tsoekere la phosphate ke bokuli bo sa tloaelehang haholo bo nang le monyetla oa 1: 20,000 oa ho bo holisa.

Ho latela lipatlisiso tsa morao-rao tsa bongaka, lintho tse futsitsoeng tsa motho li kenyeletsa mefuta e fetang likete tse 28.

Lefu la tsoekere la phosphate ke lefu le amanang le tlhaho;

Lefu lee ke eng?

Lefu la tsoekere la phosphate ke lebitso le tloaelehileng bakeng sa mafu a tlhaho, litšobotsi tsa ona ke:

ho haella ha phosphorus 'meleng,
kholo ea lefu la masapo,
ponahalo ea matšoao a kang a rickets.

Lefu la tsoekere la phosphate ke lefutso le sa amaneng le tlolo ea tlhahiso ea "insulin" makhophong le bongata ba tsoekere maling. Lefu lena le bakoa ke metabolism e sa lokang ea vithamine D, hammoho le phosphates. Ka ts'oaetso ea lefu la tsoekere la phosphate, ha ho na mokhoa oa ho khutlisetsa lintho tsena ka har'a lipompo tsa masapo, 'me lisele tsa masapo li tšoauoa ka tšebeliso e fosahetseng ea khemikhale.

Ho nkoa e le tlolo ea molao e fumanehang seoelo, monyetla oa ntlafatso ea eona ke 1: 20,000. Ho thehoa ha lefu la tsoekere la phosphate ha ho amane le tšenyo ea manyeme le ho eketseha ha tsoekere ea mali. Lefu lena, joalo ka lefu la tsoekere, le na le tšoaetso ea lefutso. Matšoao a eona a hlahisoa ke 'nete ea hore phosphorus ha e kenngoe maling ka methapong ea kutlo. 'Meleng, khatello ea mali ea eona ea fokotseha, sebopeho sa lisele tsa masapo se senyehile, e leng se lebisang bofokoling sebopeng sa skeleton le anomalies ka sebopeho sa' mele.

N25.1 "lefu la tsoekere la lefu la tsoekere"
N25.8 Mathata a mang ka lebaka la ho hlobaela ha methapo ea methapo

Lisosa tse ka sehloohong le pathogeneis

Lefu lena le tšoauoa ka ho senyeha ha reabsorption (reverse absorption) ea phosphates ho proximal tubules ea liphio, e lebisang ho fokotseha hoa boemo ba tsona ka serum. Ketsahalo ena e amana ka kotloloho le tlhekefetso ts'ebetsong ea osteoblasts - lisele tse nyane tsa masapo. Ka lebaka leo, ho kenngoa ka popelong ea phosphates, calcium le vithamine D ho fokotsehile.

Boloetse bona ke litholoana tsa phetoho ea ka mpeng ea X chromosome, e sitisang ho kenngoa ha phosphates ka har'a lipompo tsa renal, 'me hamorao e baka lethathamo la methapo ea methapo e sitisang ho kenngoa ha calcium ka bongata ke lithane tsa lesapo.

Banna ba nang le lefutso le nang le sekoli ba fetisetsa lefu lena ho barali ba bona.
Basali ba jereng mofuta o senyehileng ba fetisetsa lefu lena ho bana ba batona le ba batšehali le bara le bona.
Ho hoholo ka ho fetesisa, bashanyana ba na le li-rickets tsa hypophosphatemic. Botsofaling, lefu lena le ka amahanngoa le hlahala lesapong kapa lithong tse bonolo.

Tlhomamiso

Ka bongaka ba sejoale-joale, mefuta e mehlano e meholo ea maloetse e khetholloa, ho latela hore na mefuta ea lefutso e bile le liphetoho life.

Mofuta o ka sehloohong o kopantsoeng le X ke mofuta o atileng haholo oa mafu, moo ho pepesitsoeng masapo a phosphates ka har'a moroto a hanang le vithamine D. Pathology e iponahatsang lilemong tse peli tsa pele tsa bophelo ba ngoana. Bala ka litekete tsa Vitamin D-Resistant
Mofuta oa lefutso la Autosomal - lefu le fumanehang seoelo, ha le utloisisoe hantle, le hlaha ka lebaka la phetoho ea liphatsa tsa lefutso, e ikarabellang bakeng sa sebopeho se tloaelehileng sa dentin, lesapo la masapo.
Mofuta oa Xessess o amanang le "X" - bajari ba mofuta o fetotsoeng ke basali, empa lefu lena le hlaha ho banna feela. Pathology e khetholloa ke motsamao o ts'oanelang oa li-ion tsa phosphate ka epithelium ea nephrons.
Mofuta o hlahelletseng oa Autosomal - o nkoa e le mofuta o bonolo ka ho fetesisa oa pathology, o tšoauoa ka ho eketseha ha li-ion tsa phosphate ka moriring, hypophosphatemia.
Mofuta oa lefu la Autosomal receptive le hypercalciuria ke mofuta o sa tloaelehang oa lefu. Ka moroto, litaba tsa phosphorus le calcium li eketseha, ka plasma ea mali boemo ba lintho tsena bo fokotseha.

Bohlokoa! Lefu la tsoekere la phosphate ke lefu le amanang le tlhaho. Sebopeho se fumanoeng ho batho ba baholo se fumanoa boteng ba li-neoplasms tse ling masapong le linama tse bonolo, tse bitsoang li-riccoic rickets.

Matšoao a pele ho bana

Lefu la tsoekere le phosphate le bonahala joang ho bana?

Ho na le ho khutla ho hoholo.
Maoto a sothile.
Manonyeletso a mangole le maqaqailana a holile.
Masapo a sebakeng sa manonyeletso a letsoho a boreleli.
Fokotsa molumo oa mesifa.
Nakong ea palpation, bohloko mokokotlong le masapo lia utloahala. Ho tšoha ho tebileng ho ka etsa hore ngoana a khaotse ho itsamaela ka maoto ka boeona.
Maemong a sa tloaelehang, bofokoli ba enamel menoana, li-rickets tsa lesapo la mokokotlo kapa masapo a pelvic lia bonahala.
Spasmophilia, e leng tšobotsi ea li-rickets tse nang le khaello ea vithamine D, e ka ba teng.
Matsoho a lesea le lecha a ka khutsufatsoa (hangata ka tsela e sa lekanyetsoang).
Ha motho a le lilemo li ngata, o ba le osteomalacia.
Litšoantšo tsa X-ray li bontša nts'etsopele ea osteoporosis, skeleton e thehiloe morao haholo.
Ka tloaelo calcium e phahameng haholo masapong.
Sebopeho sa li-electrolyte, li-amino acid tsa mali, creatinine, CBS ha e fetoloe.

Ngoana o hloka palo e kholo ea lintho tse thusang le tse fanang ka phepo e nepahetseng, ho kenyelletsa phosphorus le calcium, bakeng sa khōlo e tloaelehileng le kholo. Ho haella ha lintho tsena nakong ea lilemo tsa pele tsa bophelo ho hlalosa ho teba ha lefu lena.

Matšoao a lefu la tsoekere

Lipontšo tsa lefu la tsoekere la phosphate ka lebaka la tsoalo ea lefu lena le tšoauoa ka ho teba ho hoholo - ho tloha thupelong e batlang e tšoana le ea mafu a sa bonahaleng. Maemo a mang a psychology (ka mohlala, ka lebaka la liphetoho tsa mofuta oa FGF23) a ka bonahatsoa feela ke hypophosphatemia le keketseho ea boemo ba phosphorine ka moroto, athe ha ho na matšoao a kliniki. Leha ho le joalo, khafetsa, lefu la tsoekere la phosphate le lebisa setšoantšong sa li-rickets tse tloaelehileng mme li hlaha bongoaneng - lilemo tse 1-2, hang hoba ngoana a qale ho tsamaea.

Thupelo ea bongaka ea lefu la tsoekere ea phosphate ke polymorphic. Hangata lefu lena le qala ho hlaha bongoaneng, empa le ka iponahatsa hamorao - ka lilemo tse 7-9. Ntle le moo, ho teba ha matšoao a hore na ho kula ho ka ba ho fapaneng le eng. Maemong a mang, lefu lena le na le mofuta oa lona 'me le bonahala ka liphetoho tse bonolo ho metabolite ea phosphorus.

Lipontšo tse joalo li tsamaisana le tlolo ea botsepehi ba enamel ea meno le nts'etsopele ea li-caries tse ngata, mokokotlo oa lesapo la mokokotlo le masapo a pelvic.

Matšoao a bontšang ho hlaha ha mathata a bophelo bo botle a kenyelletsang kholo ea lefu la tsoekere ke a latelang:

Ho theoha ha maemo ka kakaretso ea ngoana.
Keketseho ea morao.
Sekhahla sa liphahlo tse tlase ka sebopeho sa o.
Liphetoho mokokotlong kapa mangoleng.
Molumo o tlaase oa mesifa.
Ka morao, ha ho luma, ho hlaha bohloko.
Ho fetola mokhoa oa lesea (ho tšoana le letata)
Tlolo ea sebopeho sa meno,
Pathological fractures,
Bohloko ba masapo, jj.

Boithuto ba kliniki bo hlalosa letšoao le ka sehloohong la lefu lena hobane motho o na le mathata le nts'etsopele ea tsamaiso ea masculoskeletal le ho fokola hoa boemo bo tlase. Hape, bathong ba nang le lefu la tsoekere la phosphate, bolelele bo bokhutšoanyane, litlolo tse sa sebetseng hantle le likarolo tse ling tsa masapo lia nkuoa, liphetoho tse bohloko, bohloko nakong ea ho sisinyeha bo ka lateloa.

Ho fokolisa mesifa, tšobotsi ea li-rickets tsa 'nete, hangata ha ho na lefu la tsoekere. Nts'etsopele ea kelello boteng bona ha e utloe bohloko.

Mathata

Ka lebaka la kalafo e sa lebelloang, bakuli ba nang le lefu lena ba ka fumana mathata a latelang:

Tlokotsi ea lesapo la mokokotlo, ka lebaka leo - maemo.
Bohloko ba kelello kapa ba mmele ho hola ngoana.
Masapo kapa bofokoli ba sefahleho bo lebisang ho holofetseng.
Pathology ea nts'etsopele ea leino, tlolo ea nako ea kholo ea bona.
Liphokotso ho nts'etsopele ea mokoetla oa patlo.
Nephrocalcinosis, e hlalosoang ke matsoai a letsoai la calcium ka monoana.

Haeba ngoana a e-na le tšekamelo ea ho holisa lefu lena, tlhahlobo ea hae e qala hang hoba a hlahe, ho thibela mathata ka moo ho ka khonehang. Ho etsa sena, ba lekola boleng ba calcium le phosphorus, ba lekola hore na skeleton e hola joang, hore na kholo e ts'oana le litekanyetso tse lokelang ho ba lilemong tsena.

Ha ho fumanoa matšoao a pele a lefu la tsoekere la phosphate, bana ba fuoa livithamini tse boletsoeng. Haeba ho hlokahala, batsoali ba ka hlophisa melemo ea hore ngoana a fumane meriana mahala, le ho hlophisa maeto a mahala likampong tse khethehileng tsa bophelo bo botle.

Ke lokela ho ea ho ngaka efe?

Ho thibela ho hlahisoa ha letsoai la calcium ka mokhoa oa majoe a liphio, boemo ba calcium bo maling le moroto bo laoloa. Ka boleng bo tloaelehileng, butle-butle u ka eketsa tekanyetso ea vithamine D.

Ntle le vithamine D, bakuli ba joalo ba khothalletsoa ho nka:

phosphorus le calcium litokisetso,
motsoako oa citrate (nakong ea likhoeli tse 6 ho ntlafatsa ho monya lintho tsena tsa ho batla),
kholo ea lihormone.

Nakong ea ts'ebetso e phahameng ea ts'ebetso, bakuli ba eletsoa hore ba phomole betheng, kamora ho fihlela phallo - ho silila ka kalafo, ho ikoetlisa ka ho ikoetlisa le ho phekola spa.

Litekanyetso tsa katleho ea kalafo e bolokehileng ke:

bophelo bo botle,
ho potlakisa kholo,
normalization of phosphorus metabolism 'meleng,
matla a radiology (ho khutlisetsoa sebopeho se tloaelehileng sa masapo).

osteotomy (masapo) a masapo a malelele a tubular ka tokiso ea lengole la maoto le matsoho.
litho tsa maoto le matsoho ke ho sitisoa ke lisebelisoa tsa Ilizarov le compression.

Ts'ebetso e joalo e lokela ho etsoa feela kamora kalafo ea nako e telele ea ho boloka matla le ho hlahloba hantle.

Mekhoa ea physiotherapy bakeng sa lefu la tsoekere la phosphate

Physiotherapy e sebelisetsoang ho kokobetsa boemo:

Therapy ea Laser Mokhoa ona oa kalafo o ntlafatsa ho sisinyeha ho kopaneng le ho fokotsa botebo ba bohloko ho bona. Mokhoa o boletsoeng o ipapisitse le phello ea mahlaseli a laser ho lithane. Tabeng ena, ts'oaetso ea ts'oaetso e felisitsoe, lits'ebetso tsa ho nchafatsa li potlakile. Borashe ba laser bo feptjoa sebakeng sa bothata bo sebelisa nozzle e khethehileng.
Magnetotherapy. Mokhoa ona o u lumella ho matlafatsa tsamaiso ea 'mele ea ho itšireletsa mafung, ho ntlafatsa bophelo bo botle ka kakaretso le ho potlakisa ho khutlisoa ha lisele tsa masapo. Mokhoa ona oa kalafo o thehiloe ho phello ea matla a khoheli ho 'mele oa motho.
Electrophoresis Fokotsa bohloko manonyeletsong le masapong. Mokhoa ona o ipapisitse le bokhoni ba tšusumetso ea motlakase ho tsamaisa lintho tsa lithethefatsi sebakeng se amehileng. Maemong ana, ho sisinyeha sebakeng sa ts'usumetso ho eketseha. Litafole tse khethehileng tse tsamaisang hona joale li behiloe kaholimo ho lenonyeletso le nang le bothata, kaha le kile la phekoloa ka tharollo ea meriana.
Ultraphonophoresis. Hoa tšoana le ka mokhoa o fetileng, leha ho le joalo, moriana o boemong bona o fihla sebakeng sa bothata ka lebaka la ho sisinyeha ha ultrasonic. Mokhoa o sireletsehile ka botlalo ebile ha o utloe bohloko.

Tsoelo-pele ea lefu la tsoekere ea phosphate e ka fapana 'me ea itšetleha ka lintlha tse ngata - mofuta oa lefu lena, ho teba ha matšoao, lilemo tsa ho khetholla lefu la methapo le tšimoloho ea kalafo e nepahetseng. Khafetsa, lefu lena le letle, empa tlhoko ea bophelo bohle ea tšebeliso ea vithamine D, calcium le phosphorous e ka tsoela pele. Mathata a tebileng a marapo a bakoang ke ho fumanwa ha nako e telele kapa kalafo e sa lokang a ka senya bophelo ba mokuli.

Thibelo

Lefu la tsoekere la phosphate ke lefu le fetisoang hoo e ka bang maemong 'ohle ho tloha ho batsoali ba kulang ho ea ho bana. Haeba ponahalo ea eona e bakiloe ke lefutso, motho kapa ngaka e 'ngoe le e' ngoe e tšoanelehang e ke ke ea susumetsa nts'etsopele ea eona mme ea behella ka thoko kotsi ea lefu.

Ho thibela ts'oaetso ea lefu lena ho etselitsoe haholo ho thibela ho hlaha ha litlamorao le ho fokotsa kotsi ea phetoho ea masapo ho bakuli ba lilemo tse fapaneng.

Boteng ba lefu la tsoekere la phosphate ho beng ka lona ba haufi, ho hlokahala hore o etele liphatsa tsa lefutso mothating oa ho rera bokhachane. Ho bohlokoa ho tseba proband - motho eo nalane ea bokuli ba lelapa e qalileng ho eena.

Ho ikoetlisa

Le lefu la tsoekere la phosphate, ho bohlokoa haholo ho phela bophelo bo mafolofolo. Bakuli ba nang le lefu la methapo ba bontšoa:

Boikoetliso ba hoseng, bo lokelang ho kenyelletsa boikoetliso bakeng sa matsoho, maoto, mokokotlo:
- ho tsamaea sebakeng
- squats
- maoto le matsoho,
ho potoloha

ho sesa, ho matlafatsang mesifa, ho fokotsa bohloko, ho na le phello e molemo tsamaisong ea pelo le pelo.

Ho sesa ho eketsa molumo oa mesifa, ho ntlafatsa tšebetso ea methapo

Mokhoa oa bophelo oa batho ba nang le lefu la tsoekere la phosphate o potlakisa nts'etsopele ea atrophy ea mesifa.

Pheko ea 'mele

Phekolo e sebetsang ea 'mele ea lefu la tsoekere e phofo

mesifa ea lipheletso tse tlase le tse holimo, tseo ho tsona phallo ea mali e ntlafalitsoeng, molumo oa mesifa o tloaelehile,
physiotherapy.

Pele, ho silila ho lokela ho etsoa ke setsebi tleleniking. Nakong e tlang, litho tsa lelapa la mokuli li ka ithuta mokhoa o nepahetseng oa ho silila le ho etsa ts'ebetso eo lapeng.

Ho rarahana ha boikoetliso ba ho ikoetlisa ho khethoa ke ngaka ka bomong bakeng sa mokuli ka mong. Lithuto tsa pele li lokela ho etsahala tlasa taolo ea setsebi, kamora hore ho ikoetlisoe ka physiotherapy ho ka etsoa lapeng.

Lijo tsa lijo

Pheko ea lijo ke ntho ea bohlokoa kalafong ea lefu la tsoekere la Fofat, e tla thusa:

tloaelehileng metabolism
ntlafatsa boemo ba lisele tsa masapo le mesifa.

Le lefu la tsoekere la phosphate, lenane le lokela ho kenyelletsa lihlahisoa:

e nang le phosphorus e ngata,
e ruisitsoe ka calcium.

Tafole: Lijo tse nang le phepo e ntle ea lefu la tsoekere

Lijo tse phahameng Phosphorus	Lijo tse nang le calcium tse ngata
lihlapi lijo tsa leoatleng soya lensisi linaoa chisi mahe.	chisi ea chisi chisi linaoa sesame seed lialmonde salemone e ratoang le sardine, khábeche spinach parsley rhubarb.

Kantle ho jao ho lokela hore lijo tse eketsang mosebetsi oa liphio le tsamaiso ea methapo ea pelo:

letsoai le fepetsang 'mele' me le ama hampe litsamaiso tsohle tsa 'mele,
Lijo tse mafura. Mafura a mangata lijong a eketsa palo ea cholesterol maling, e ka bakang nts'etsopele ea methapo ea methapo. Hape, lijo tse nang le mafura li mpefatsa metabolism, li eketsa moroalo lipelong,
lijo tse nokiloeng ka linoko, tse khaotsoeng le tse tsubeloang. Lihlahisoa tse joalo li khopisa lera la mucous la pampiri ea urine,
joala Lino tse nang le joala tse ngata li eketsa khatello ea mali, li kenya letsoho kholisong ea arrhythmia, e chefo 'meleng ka lintho tse nang le chefo.

Phekolo ea kalafo le litlamorao tse ka hlahang

Katleho ea kalafo ea lefu la tsoekere la phosphate e ipapisitse le likarolo tse latelang:

nako ea tlhahlobo,
tsebo ea kalafo e ngotsoeng
diketso tse nepahetseng tsa mokuli kapa batswadi ba hae (haeba re bua ka ngoana ea nang le lefu la tsoekere la phosphate).

Mathata a tloaelehileng a lefu la tsoekere a phosphate a kenyelletsa:

urolithiasis,
osteoporosis (fokola masapo a masapo),
scoliosis (mokokotlo oa karolo ea lesapo la mokokotlo),
arrhythmia (pherekano ea morethetho oa pelo),
khatello ea mali ea methapo (khatello e phahameng ea khatello ea mali),
likhahla tsa maoto le matsoho.

Phello e bohloko ka ho fetisisa ke ho se khone ho sebetsa hantle ha mokuli.

Lisosa tsa lefu la tsoekere la Phosphate

Ho ipapisitse le lisosa tsa phosphate, lefu la tsoekere le ka khethoa ka liphatsa tsa lefutso ho tloha ho batsoali ba kulang ho ea ho bana kapa ea ba pontšo ea li-benign tumors (oncogenic rickets).

Ho hoholo ka ho fetesisa, bashanyana ba na le li-rickets tsa hypophosphatemic. Botsofaling, lefu lena le ka amahanngoa le hlahala lesapong kapa lithong tse bonolo.

Ka lefu la tsoekere la phosphate, mathata a joalo a ba teng:

Kholo ea masapo
Ho nolofatsa masapo
Phetoho ea manonyeletso a mangole le mangole
Keketseho e potlakileng ea ho holofala leoto le tlase.

Matšoao a lefu la tsoekere la phosphate ea bongoaneng

Lipontšo tse joalo li tsamaisana le tlolo ea botsepehi ba enamel ea meno le nts'etsopele ea li-caries tse ngata, mokokotlo oa lesapo la mokokotlo le masapo a pelvic.

Matšoao a tšoaetso ea lefu la tsoekere la Fofat ke:

Molumo o theohile oa mesifa.
Spasmophilia.
Mokokotlo o nang le sebopeho sa maoto.
Pseudo-fractures le bofokoli ba masapo.
Ho khutsufatsa ha maoto le matsoho khafetsa ha ho arabeloe

Tlhahlobo ea lefu lena

Tlhahlobo ea X-ray e senotse diaphysis tse ngata (karolo e bohareng ea lesapo la mokokotlo), masapo a masapo a masapo, osteoporosis, sebopeho sa masapo a butle, masapo a na le calcium e ngata.

Hape, ha ho etsoa tlhahlobo ea bongaka, ho fumanoa ha phosphates ka moriring ho phahame ho feta boleng bo tloaelehileng.

Ntle le moo, ho bakuli, ka linako tse ling mosebetsi o eketsehileng oa alkaline phosphatase le calcium e tlase maling li ka fumanoa haeba kalafo e nang le tekanyetso e phahameng ea phosphorous e boletsoe.

Phekolo ea lefu la tsoekere

Ntle le moo, mefuta e latelang ea kalafo e fuoe bakuli:

Phekolo ea Vitamin e nang le tocopherol (vithamine E) le vithamini A.
Khetho ea corset ea orthopedic bakeng sa tokiso ea mokokotlo oa mokokotlo oa hau.
Qetellong ea kholo, kalafo ea ho buoa e ka etsoa ka bohlokoa ba deformation ea masapo.
Ka lefu la tsoekere la oncogenic phosphate, hlahala ea tlosoa.

Ha lefu lena le se le fetile molemong oa ho ikatela ha bongaka le kalafo, bakuli ba fuoe ts'ebetso ea ho boloka mmele ka thibelo ea ho tlola le ho ikoetlisa ka matla.

Ho khothalletsoa ho etsa mokhoa oa ho silila ka kalafo, libate tsa letsoai le li-whirlpool, kalafo maemong a sanatorium.

Liphello le mathata

Khetho ea boraro e qala ha a le lilemo li hlano, masapo a senyehile haholo, calcium e maling e ea fokotseha, 'me calcium le phosphates ha li kenngoe ka mpeng. Vitamin D e bontšitse ho hanyetsa.

Mathata a lefu la tsoekere a phosphate a kenyelletsa:

Tlokotsi ea boemo ba maemo le liphokoletso tsa likarolo tse tlase.
Ho khutlisetsoa 'meleng le ka linako tse ling kelellong.
Ho etsoa le meno le meno lia senyeha.
Ho hlahisoa ha calcium ho liphio.
Mathata a ho tsamaisa (karolo ea Caesarean ea hlokahala).

Ka video e sehloohong sena, Dr. Komarovsky o bua ka khaello ea vithamine D.

Mabaka le lintlha tsa nts'etsopele

Sesosa se ka sehloohong sa lefu lena ke ho hlohlona ha lipompo ka lebaka la liphatsa tsa lefutso. Tsela e fosahetseng ea mosali oa moimana, tšebeliso ea hae ea joala, le ts'ebeliso ea koae kapa lithethefatsi li ka baka ts'ebetso e ts'oanang ea pathological. Kotsi ea mafu a joalo e eketseha ho batho bao beng ka bona ba nang le lefu la tsoekere. Ho feta moo, ho batla ho le thata ho qoba lefa la lefu le joalo.

Lintlha tse ling tse tsosang:

ho sebelisa lithethefatsi tse matla nakong ea pele ea boimana,
Toxicosis e matla,
likhohlano tsa rhesus.

Ho latela lipalo-palo, maemong a mangata, lefu lena le fetisoa ho tloha ho ntate ho ea ho morali, leha ho na le mefuta ea lefa le bo-mme.

Setšoantšo sa Clinical

Lilemong tsa pele tsa bophelo ba 1-2, li-pathology li kanna tsa se ke tsa bonahala ka tsela efe kapa efe. Ntho feela e bonts'ang lefu lena ke dikahare tsa phosphorus ion ka har'a moroto. Ha ngoana a qala ho tsamaea, joale ts'ebetso ea methapo ea methapo e iketsa ea ikutloang. Tabeng ena, maoto a holofetse, a bileng a nang le sebopeho sa O. Ngoana o boetse o na le bofokoli ba mesifa le ho sitoa ho etsa mesebetsi e tloaelehileng.

kholo e holang
bofokoli ba mmele
tahlehelo ea moriri
ho senyeha ha meno
bohloko bo boholo ba mokokotlo
li-fractures tse sa feleng.

Ka lefu la tsoekere la phosphate, masapo a leoto a nolofala 'me a fetoha brittle

Haeba a sa phekoloe, lefu le tsoela pele, bohloko bo boholo masapong le manonyeletsong a hlaha, ka lebaka leo ngoana a lahleheloa ke bokhoni ba ho sisinyeha ka botlalo.

Mekhoa ea ho Tseba

Mekhoa ea ho etsa lipatlisiso e sebelisetsoang ho khetholla lefu la tsoekere:

Tlhahlobo ea moroto le mali. E lumella ho bona maemo a phosphorus ho plasma le urine. Khetlong la pele, palo ea li-ion e fokotseha haholo, 'me ea bobeli, ho fapana le hoo, ea eketseha. Setšoantšo sena se re lumella ho belaella boteng ba lefu la tsoekere.
CT le MRI. Tomografik e kopantsoeng e etsa hore ho khonehe ho fumana litlolo tse ka sebopeho sa masapo. Maemong ana, o ka bona bofokoli bofe kapa bofe setšoantšong. Khopolo ea maqhubu a matla a khanya e tšoana le tomography e lekantsoeng, ha feela e sa sebelisoe, ho sebelisoa radiation ea x-ray, empa matla a nyutlelie a nyutlelie. U sebelisa mokhoa ona, u ka fumana litšoantšo tse qaqileng ho tsoa ho likarolo tse fapaneng tsa masapo le manonyeletso.
X-ray Ke mokhoa oa khale oa ho etsa lipatlisiso khahlano le sebopeho sa masapo. Setšoantšong u ka bona tšobotsi ea lefu lena. Maemong ana, masapo a fetoha mosesaane ebile a hanela khatello ea khatello.

MRI ke e 'ngoe ea mekhoa e theko e boima empa e le e nepahetseng ea ho etsa lipatlisiso ka lefu la tsoekere.

Ho feta moo, ho ka sebelisoa tlhahlobo ea lipatlisiso tsa liphio, moo ho fumanoang liphetoho tse fokolang haholo tsa sebopeho sa litho. Tabeng ena, o ka fumana lehlabathe le majoe, ao hangata a amanang le lefu lena.

Mekhoa ea phekolo

Psychology ena ha e phekolehe, empa ka mokhoa o kopaneng oa kalafo, hoa khoneha ho emisa tsoelo-pele ea lefu lena. Bakeng sa merero ena, ho sebelisoa meriana, physiotherapy le lijo tsa ja. E le mokhoa o thusang, ho sebelisoa mekhoa e meng. Maemong a tsoetseng pele, buella ho kenella ha ho buuoa. Ho tlama ke ho roaloa ha mekhabiso e ikhethang ea methapo - mabanta a thibelang mokokotlo le bohloeki ba lesapo la mokokotlo.

Phofu ea Lefu la Ts'oaetso ea Phosphate e Thibela Mokokotlo oa Spinal

Ho kopantsoe ha phekolo ea lithethefatsi le physiotherapy ho ka ntlafatsa boemo bo tloaelehileng ba motho ea kulang, hammoho le ho tlosa kapa ho fokotsa bohloko.

Phekolo ea lithethefatsi

Lihlopheng tse latelang tsa meriana ho sebelisoa kalafo ea kalafo:

Litokisetso tse nang le letsoai la phosphate ea calcium: Osteogenon, Tridine, jj. Lithethefatsi tse joalo li ntlafatsa boemo ba lithane tsa masapo, li thibela ho fetofetola le liphetoho tsa pathological ka sebopeho sa manonyeletso. Meriana e fanoa bakeng sa thupelo e telele (ho tloha likhoeli tse 6 kapa ho feta).
Vitamin D: Aquadetrim, Ultra-D, joalo-joalo. Lithethefatsi sehlopheng sena li bohlokoa bakeng sa ho monya ka botlalo ha ion ea phosphorous le ho fokotsa ho tsoa ha tsona ka har'a moroto. Motsoako oa vithamine o eketseha butle-butle, tsela ea kalafo le eona e telele.
Litokisetso tse nang le khalsiamo: Fitin, calcium calciumconate le ba bang. Meriana ea sehlopha sena e matlafatsa masapo, e thibela liphetoho tsa methapo le ho ntlafatsa boemo ba meno. Meriana ena e baka khaello ea khalsiamo ka tahlehelo e mafolofolo ea liminerale tsena. Sena se ntlafatsa boiketlo ka kakaretso le lefu la tsoekere la phosphate. Nako ea kalafo e tsoa likhoeli tse 'maloa ho isa ho likhoeli tse tšeletseng.
Vitamin E: Tocopherol acetate, Aevit le ba bang. Meriana e tsoang sehlopheng sena e na le phello ea antioxidant, e ntlafatsa bophelo bo botle 'me e na le phello e molemo maemong a setho sohle.

Phekolo ea lithethefatsi e ka thibela tsoelo-pele ea lefu lena mme ea thusa ho matlafatsa sebopeho sa masapo, ea fokotsa tahlehelo ea phosphorus le calcium ka hara moroto.

Ho buoa

Opereishene e etsoa hape ka ho leka-lekana ho holofala ho matla ha maoto. Sena sea hlokahala ha mekhoa e meng e sa atlehe. U ka fetohela mokhoeng ona oa kalafo kamora ho fela ha kholo ea masapo. Ka ts'ebetso ea bongaka e sebelisang thipa, maoto le matsoho a senyehileng a lokisoa ka masale a khethehileng a lohang. Pele ho tsohle, lesapo le tšeletsoe, ke hore, le robehile 'me le falliselitsoe sebakeng se nepahetseng. Ebe u lokisa sebakeng se lakatsehang u sebelisa sebopeho sa tšepe (mokhoa oa Ilizarov).

Pholoso e telele. Ts'ebetso e etsoa tlasa khatello ea kelello e akaretsang. Litlhoko ha li tlosoe lesapo ho fihlela e hlatsuoa ka botlalo boemong bo nepahetseng. Ka mokhoa ona, o ka tlosa bohloko bo sa feleng. Ka bomalimabe, ka bofokoli bo matla, mokhoa ona o ke ke oa sebelisoa kamehla.

Khalemelo ea bofokoli ba masapo ka mor'a ho buuoa ho latela mokhoa oa Ilizarov

Bophahamo ba ts'ebetso bo khethoa ke ngaka ka mor'a tlhahlobo ea mali le ho fumana li-x-ray. Ka tšenyo e kholo ea lisele tsa masapo, ts'ebetso ea ts'ebetso e etselitsoe ho khutlisa libaka tse amehileng.

Ho kenella ha opereishene ho u lumella ho tlosa mokokotlo oa maoto, ao hangata a tsamaeang le bakuli ba lefu la tsoekere la phosphate.

Litlhare tsa setso

Mokhoa ona o etselitsoe ho matlafatsa 'mele le ho ntlafatsa mekhoa ea metabolic. Lisebelisoa tsena li ka se felise lefu la tsoekere la phosphate mme ha li ame ho fufuleloa ha phosphorus. Mekhoa e meng e ka sebelisoang ho ntlafatsa boemo ba liphio le 'mele ka kakaretso:

Motsoako oa Nut. Ho phethela khaello ea lintho tse senang mohlala, ho ntlafatsa sesole sa 'mele. U tla hloka li-walnuts, almonds le hazelnuts ka foromo e omisitsoeng. Lithako tsohle li hloka ho tsoakoa ka bongata bo lekanang (100 g e ngoe le e ngoe), ebe u eketsa 2 tbsp. l mahe a linotsi. Motsoako o hlahisitsoeng o khothalletsoa ho grind ka blender ebe o sebelisa 1 tbsp. l Makhetlo a 3 ka letsatsi 1 hora ka mor'a lijo. Nako ea kalafo ke khoeli e le 'ngoe.
Pholiso ea pholiso. E matlafatsa ts'ireletso ea 'mele, e ntlafatsa ts'ebetso ea liphio. E tla hloka stigmas tsa poone ka bongata ba 1 tbsp. l., e hlokang ho tšela 300 di ml ea metsi a belang ebe e li tlohella lihora tse peli. Ka hona, sefa metsi, 'me u noe makhetlo a 100 ka makhetlo a 3 ka letsatsi metsotso e 15 pele u ja. Nako ea kalafo ke libeke tse peli.
Motsoako o thibelang ho ruruha. E ntlafatsa ts'ebetso ea liphio, e matlafatsa sesole sa 'mele. U tla hloka ho kopanya palo e lekanang ea lipalesa tsa chamomile le calendula. 1 tbsp. l tšela 400 ml ea metsi a belang ebe u pheha ka mocheso o tlase ka metsotso e 15. Ebe metsi a pholile ebe a sefa. Moro o itokiselitseng ho nka makhetlo a 100 ml makhetlo a 3 ka letsatsi hora e le ngoe ka mor'a ho ja. Nako ea kalafo ke matsatsi a 10.
Pholiso ea libeso. E tla thusa ho tlosa bohloko masapong le manonyeletsong. Hoa hlokahala ho theola bateng, mocheso oa metsi moo o sa lokelang ho feta likhato tse 41. Ho 2 tbsp. l letsoai la leoatleng o hloka ho eketsa marotholi a 3 a phaene ea oli ea bohlokoa. Ntho ea bohlokoa ha se ho e fetelletsa! Ebe u qhala letsoai ka metsing. Hlapa bakeng sa metsotso e 15-20. Pheta ts'ebetso kamoo ho hlokahalang.

Litlhare tsa Folk li ke ke tsa sebelisoa ho phekola bana ba ka tlase ho lilemo tse 12. Mekhoa ena e etselitsoe batho ba baholo feela. Ha rea lokela ho lebala hore 'mele oa bana o tsotile haholo ebile o ka' na oa se ke oa arabela ka mekhoa e joalo ea kalafo ka tsela e molemohali.

Kelello le mathata

Ka mokhoa oa kalafo o tlang ka nako, kalafo e ntle. Ho ja khafetsa k'halsiamo, vithamine D le phosphorus ho thusa ho ntlafatsa bophelo bo botle. Leha ho le joalo, lintho tsena li tla tlameha ho nkuoa ho fihlela qetellong ea bophelo e le pheko ea tlhokomelo. Haeba lefu le qalile, u ka kopana le mathata a mangata a kang:

leoto le holofetseng
spinal curvature,
e robehang ka ho sa feleng esita le ka likotsi tse nyane le ho oa,
ho hloka taolo,
sebopeho sa calculi lipelong.

Phekolo ea pejana ea lefu la tsoekere e phofo e qalile, e ba betere ho ngoana. Haeba lefu le fumanoa selemong sa pele sa bophelo mme ka nako e tšoanang kalafo e loketseng e etsoa, menyetla ea litlamorao tse kotsi e tlase.

Mehato ea thibelo

Ka bomalimabe, ho ke ke ha khoneha ho thibela lefu la tsoekere la phosphate, hobane lefu lena ke lefa. Leha ho le joalo, o ka fokotsa kotsi ea litlamorao tse kotsi bakeng sa 'mele, haeba u latela melao e bonolo ea thibelo:

E ja hantle 'me u noe metsi a mangata.
Nka li-complexes tsa vithamine tse nang le vithamine D, calcium le phosphorus.
Tlhahlobo ea ngaka khafetsa: nka tlhahlobo ea mali le moroto ka kakaretso, tlhahlobo ea liphio.
Hangata ho ba moeeng o mocha.
Se ke oa nka lithethefatsi tse nang le matla ntle le taelo ea ngaka.

Teko ea mali eu lumella ho laola boemo ba phosphorus

Ho fokotsa kotsi ea bokuli ho lesea le e-so hlahe, hoa hlokahala ho bona setsebi sa lefutso ha u rera ho ima.

Karolo ea vithamine D ho thibela mathata a metabolism ea phosphorus - video

Lefu la tsoekere la phosphate ke lefu le kotsi le ka bakang khaello e kholo ea masapo. Ka nako e ts'oanang, motho ha a utloe feela ho phela hantle 'meleng, empa hape le ho se khotsofale kelellong, ka hona ho bohlokoa haholo hore a se ke a hlokomoloha matšoao a pele a pathology. Ho ja lithethefatsi tse nang le vithamine nako e telele ho tla thusa ho ntlafatsa bophelo bohle.