Glycated hemoglobin ha ho fumanoa lefu la tsoekere

Ka lebaka la ho ata ha lefu la tsoekere la tsoekere, ho khonahala ha mathata a teng kapele le ka potlako, palo e kholo ea linyeoe tse sa tsejoeng le ponelopele e nyahamisang ea WHO mabapi le tebello ea ho ata ha lefu la tsoekere lefats'eng, ho fumanoa ka nepo le ka nepo ha lefu la metabolism ea carbohydrate ho bohlokoa. Glycated hemoglobin ke sesupo sa hore, ha u sebelisa mekhoa e lekantsoeng, e fana ka mohopolo o kopaneng oa boemo ba glycemia ka nako e telele mme o thusa ho lemoha tlolo ea nako ea metabolism ea carbohydrate. Ha o sebelisa hemoglobin ea glycated e le sesupo sa tlhahlobo ea mafu a metabolism ea carbohydrate kapa tekanyo ea matšeliso bakeng sa lefu la tsoekere, ho bohlokoa ho khetha mokhoa oa ho khetholla letšoao lena o nahanela ho ts'epahala hoa lona.

Karolo ea Glycated Hemoglobin ho Thibela le ho beha leihlo lefu la lefu la tsoekere.

Cons> lefu la tsoekere, ho ba le monyetla oa ho ata ha lefu la tsoekere lefatšeng ka bophara le tlhahlobo e nepahetseng le e nepahetseng ea mathata a metabolism ea carbohydrate e bohlokoa. Hemoglobin ea glycated ke sesupo sa hore, ha ba ntse ba sebelisa mekhoa e lekantsoeng, ho hlahisa hemoglobin e le sesupo sa tlhahlobo ea mafu a metabolism ea carbohydrate metabolism kapa tekanyo ea puseletso ea lefu la tsoekere, mokhoa o nepahetseng oa khetho ea mokhoa oa qeto ena ea index. ho tšepahala, ho bohlokoa.

Lingoloa tsa saense e mabapi le karolo ea glycated hemoglobin tlhokomelong le tlhokomelong ea lefu la tsoekere.

Kiev City Clinical Endocrinology Center

Karolo ea hemoglobin e glycated ho hlahlobeng le ho lekola lefu la tsoekere

Kakaretso Ka lebaka la ho ata ha lefu la tsoekere la tsoekere, ho khonahala ha mathata a teng kapele le ka potlako, palo e kholo ea linyeoe tse sa tsejoeng le ponelopele e nyahamisang ea WHO mabapi le tebello ea ho ata ha lefu la tsoekere lefats'eng, ho fumanoa ka nepo le ka nepo ha lefu la metabolism ea carbohydrate ho bohlokoa. Glycated hemoglobin ke sesupo sa hore, ha u sebelisa mekhoa e lekantsoeng, e fana ka mohopolo o kopaneng oa boemo ba glycemia ka nako e telele mme o thusa ho lemoha tlolo ea nako ea metabolism ea carbohydrate. Ha o sebelisa hemoglobin ea glycated e le sesupo sa tlhahlobo ea mafu a metabolism ea carbohydrate kapa tekanyo ea matšeliso bakeng sa lefu la tsoekere, ho bohlokoa ho khetha mokhoa oa ho khetholla letšoao lena o nahanela ho ts'epahala hoa lona. Mantsoe a bohlokoa: lefu la tsoekere, hemoglobin ea glycation, glycation, taolo ea glycemic.

Lefu la tsoekere mellitus (DM) hajoale ke bothata bo tebileng ba bongaka le sechabeng. Ho latela bolepi ba WHO, ka 2030 palo ea bakuli ba nang le lefu la tsoekere e tla feta limilione tse 592. Empa bothata ha bo felle feela ho ata ha lefu la tsoekere, empa hape le ntlafatsong e potlakileng ea mathata a lebisang ho fokotseheng hoa boleng ba bophelo ba mokuli, ho holofala le lefu. Bakeng sa bakuli ba nang le lefu la tsoekere, nts'etsopele ea pele le khatello e phahameng ea methapo ea methapo e hlahella: mofuta oa 2 - macrovascular (tšenyo ea methapo ea methapo, methapo ea methapo le methapo) le microvascular (retinopathy, nephropathy, neuropathy), e nang le mofuta oa 1 - microvascular. Karolo ea mofuta oa lefu la tsoekere la mofuta oa bobeli ke ho ba teng ha mathata a sa foleng ka nako ea ho theha tlhahlobo ea bongaka, e eketsang lefu lena le ho thatafatsa menyetla ea matšeliso.

Hajoale, bakuli ba limilione tse 1,3 ba nang le lefu la tsoekere ba ngolisitsoe Ukraine. Ho feta moo, tlhaiso-leseling e tsoang liphuputsong tsa mafu a tšoaetso e bontša hore palo ea bakuli ba nang le lefu la tsoekere ha le makhetlo a 2-2,5 ho feta palo ea bakuli ba tsebahalang. Kahoo, ho lingaka tsa endocrinologists, litsebi tsa bongaka, le lingaka tsa malapa, bothata ba ho hlahloba lefu la tsoekere la khale bo bohlokoa.

E 'ngoe ea mekhoa ea ho bona mathata a metabolism ea carbohydrate ke ho tseba boemo ba glycemia. Re lokela ho hopola hore sephetho se bonts'a khatello ea tsoekere feela

nakong ea pokello ea mali, le boleng ba glycemia bo na le phapang e kholo ea motšehare. Kahoo, khokahano lipakeng tsa tekanyo ea glucose e ikhethileng le boemo ba sebele ba glycemia ha bo na matla, ka hona ho ke ke ha khonahala ho fihlela qeto ea hore mokuli o na le tšilafalo ea 'mele ea metabolism e sa tšepahaleng kapa e sa fumaneheng lipakeng tsa litekanyo. Litlhahiso tsa WHO (2006) li bonts'a hore maemong a 30% ho ka se khonehe ho fumana lefu la tsoekere o sebelisa litlhaloso tsa glycemia e potlakileng.

Letšoao le fanang ka mohopolo o kopaneng oa boemo ba glycemia ka nako e telele ke glycated hemoglobin (L1L1c). Lithuto tse ngata li tiisa kamano pakeng tsa Lyb1c le boemo ba glycemia ba mokuli 2, 3.

Ka har'a lingoliloeng tsa mahlale morao tjena, mohopolo o hlahisitse mekhoa e 'meli e shebahalang e ts'oana - glycosylation le glycation. Glycosylation, kapa ho e-na le hoo, tlolo ea litlatsetso, ke phetiso ea masala a monosaccharide ho e 'ngoe ea monosaccharide ka ho theha selekane sa glycosidic, e leng ketsahalo ea enzymatic. Glycation (glycosylation e senang enzymatic

tsebo) ke tlatsetso e senang enzymatic ea masala a monosaccharide ho sehlopha sa amino sa protheine (peptide kapa amino acid) ka sebopeho sa motheo oa Schiff, ebe ketamine. Ho hlokahala maemo a latelang molemong oa ts'ebetso ena: 1) ho ba teng ha lihlopha tsa MAHALA tse sa lefelloeng le tse senang protheine, 2) boteng ba li-aldehydes, 3) nako e lekaneng ea ho ikopanya, 4) bokhoni ba protheine ho fetola kapele confonc le ho khutlela boemong ba eona ba pele. Ka mantsoe a mang, lentsoe "glycated hemoglobin" le bontša ka botlalo ts'ebetso ea khokahano e khethehileng ea hemoglobin ea lisele tse khubelu tsa mali le tsoekere. Ho supa keketso ea tsoekere e se nang enzymatic ho protheine, IUPAC (International Union of Pure and Applied Chemistry) Khokahano e Kopaneng ea Biochemical Nomenclature e khothaletsa tšebeliso ea lentsoe "glycation", e loketseng poleloana e reng "glycosylation" e senang enzymatic. Ho na le mefuta e fapaneng ea li-hemoglobin tse glycated: LABA1a, HbA1b, HbA1c. Ke phapang ea HbA1c feela e fanang ka tumellano le boima ba lefu la tsoekere. Ts'ebetso ea glycation ha e fetohe, lebelo la eona (hammoho le khatello ea HbA1c) e lekana hantle le boemo ba glycemia.

Ho batho ba phetseng hantle, khatello ea HbA1c maling e tsoa ho 4 ho isa ho 5.9%, ho bakuli ba nang le lefu la tsoekere, boemo ba bona bo ipapisitse le boemo ba hyperglycemia. HbA1c e hlahisang e bokellana kahare ho lisele tse khubelu tsa mali mme e phehella bophelo bohle ba sele e khubelu ea mali. Kaha lisele tse khubelu tsa mali tse potileng maling li na le lilemo tse fapaneng, ho khothaletsoa ho shebisisa bophelo ba halofo ea lisele tse khubelu tsa mali - matsatsi a 60. Kahoo, khatello ea HbAk e bonts'a boemo ba mokuli ba glycemia 60 (ho fihla ho 90) matsatsi pele ho thuto. Tšusumetso e kholo holima tekanyetso ea HbA1 (, e ba le matsatsi a 30 a ho qetela pele ho ho hlahlojoa. Boemo ba glycemia nakong ena ke ka lebaka la 50% ea boleng ba HbA1 (, ka hona, boleng ba ho khetholla HbA1 (, ka hore e tšoaea boemo bo akaretsang ba tsoekere maling maling ka nako e telele) nako ea nako, ke hore, boemo ba metabolism ea carbohydrate likhoeling tse 2 tse fetileng.

Ho tloha ponong ea boleng ba kliniki, tlhaloso ea HbA1c e na le melemo e 'maloa ha e bapisoa le boikemisetso ba glycemia:

- sephetho sa HbA1c ha se ea itšetleha ka takatso ea lijo (hoa tsebahala hore ha se ka mpeng), ho ikoetlisa ka 'mele, boemo ba maikutlo ba mokuli,

- sampole ea mali e ka etsoa ka nako efe kapa efe: HbA1c e tsitsitse ka mocheso o fapaneng le nako ea nako,

- bokhoni ba ho boloka sampole ea mali ho tseba HbA1c ka 2-8 ° C matsatsi a ka bang 7,

- e na le phapang e fapaneng haholo ea tlhaho.

Ho na le khokahano e tobileng lipakeng tsa boleng ba HbA1c le boemo ba glycemia (pele ho le postprandial), bo hlahisitsoeng ka Lethathamo. 1.

Ho ka hlalosoa ho thata ho hlalosa litlhaloso tsa HbA1c. Ho hasanngoa ha boleng ba HbA1c ho batho ba babeli ba nang le tekanyo e lekanang ea tsoekere ea mali ho ka fihla ho 1%, e leng lebaka la ho ba teng phapang ho liteknoloji tsa laboratori le phapang e pakeng tsa bakuli. Sena se tiisa bohlokoa ba ho etsa mekhoa e tšoanang ea ho etsa lipatlisiso.

Tekanyetso ea mekhoa ea lipatlisiso tsa hemoglobin e glycated

Thutong ea HbA1c, ho hlokahala hore u nahane ka mokhoa oa boikemisetso ba ona le ts'ebetso ea ho sekaseka mokhoa o sebelisitsoeng. Mashome a seng makae a fetileng, ho ne ho se na maemo a tšoanang a mekhoa ea ho lekanya HbA1c, e ileng ea fokotsa katleho ea tleliniki ea ho sebelisa tlhahlobo ena. Ka 1993, American Clinical Chemistry Association e ile ea theha Lenaneo la Naha la Glycohemoglobin Nationalization Program (NGSP). Hajoale, baetsi ba lits'ebetso tsa liteko tsa HbA1c ba tlameha ho etsa tlhahlobo le ho fumana setifikeiti sa DCCT sa tumellano (DCCT - Taolo ea Taolo ea Lefu la tsoekere). American Diabetes Association (ADA) e khothalelitse hore lilaboratorori tsohle li sebelise liteko tse netefalitsoeng tsa NGSP 6 feela, tlhokahalo e ka sehloohong ea mekhoa ea NGb bakeng sa ho khetholla HbA1c ke ho ikatisa hape ka coeffanele ea phapang (CV) e ka tlase ho 4%. Ka bomalimabe, mekhoa e sebelisoang litsing tsa mesebetsi ea matsoho ha se kamehla e fihlelang litlhokahalo tsena. CV e tlase e bohlokoa haeba boemo ba mali ba mokuli HbA1c bo le haufi le meeli e behiloeng bakeng sa matšeliso a DM. Boleng ba CV bo kaholimo ho 5% bo etsa hore ho se khonehe ho sebelisa tlhaloso ea HbA1c bakeng sa tlhahlobo ea mafu, hobane e tla lebisa ho utluoang hampe ka leshano.

Ho fihla joale, mekhoa e fetang 20 ea ho khetholla HbA1c ea tsebahala. Nako le nako, li ka aroloa ka chromatographic (fluid chromatography, affili chromatography), electrophoretic, immunochemical, colorimetric. Mokhoa o mong le o mong o na le melemo le likotsi tsa oona (tafole. 2).

Lethathamo 1. Ho lumellana le litekanyetso tsa Tarb tsa HbA1c

litekanyetso tsa tsoekere ea plasma pele le ea postprandial plasma

HbA1c,% tsoekere ea lero la plasma, mmol / L tsoekere ea plasma lihora tse 2 kamora lijo, mmol / L

Ha ke fumane seo o se hlokang? Leka ts'ebeletso ea khetho ea lingoliloeng.

2) tebello ea bophelo (tebello ea bophelo). Mohopolo ona o u lumella ho lekola boemo ba mokuli le menyetla ea ho ba le mathata a methapo (esita le ho feta lilemo). Ka hona, lipheo tsa taolo ea glycemic li kanna tsa thatafala ho bakuli ba nang le tebello ea bophelo ea 10%), C le S

Khatello e tlase ea ion le phapanyetsano ea chionatography - Litokellano tse ntle le HPLC - Tlhokahalo ea mohlala - Tlhahiso e tlase, tšitiso e teng pela HbF

Chromatography ea Microcolumn - Litsenyehelo tse tlase haholo - Ha li fihlelle litlhoko tsa NGSP - Lits'enyehelo tse phahameng tsa basebetsi

Lethathamo 3. Lipheo tsa kalafo ha ho phekoloa lefu la tsoekere la mofuta oa 2

Lipakane tsa lipilisi (liphetho tsa laboratori)

id ,, ,, 1c 'Boemo bo amohelehang ho bakuli ba bangata, ha ke fumane seo u se hlokang? Leka ts'ebeletso ea khetho ea lingoliloeng.

4) kotsi ea ho ba le hypoglycemia e matla. Monyetla oa taolo e matla ea glycemic e lekanyelitsoe hobane o kenyelletsa kotsi ea lefu la pelo le pelo.

Lipheo tsa phekolo ea kalafo ea lefu la tsoekere la mofuta oa 1

Ho ea ka tataiso ea hona joale (ADA, 2013), boleng ba HbA1c ha ke khone ho fumana seo u se hlokang? Leka ts'ebeletso ea khetho ea lingoliloeng.

0-6 Ha ke fumane seo o se hlokang? Leka ts'ebeletso ea khetho ea lingoliloeng.

1. Mokhatlo oa Machaba oa Lefu la tsoekere, lefu la lefu la tsoekere. - 6h ed. // Mokhatlo oa Machaba oa lefu la tsoekere. - 2013. - 159 li-ruble.

2. Gonen B.A. Hemoglobin A1: Letšoao la taolo ea metabolic ea bakuli ba lefu la tsoekere / B.A. Gonen, A..H. Rubinstein, H. Rochman et al. // Lancet. - 1977. - Moq. 310. - P. 734-737.

3. Koenig R.J. Correlation ea melaoana ea tsoekere le hemoglobin Ac ho lefu la tsoekere mellitus / R.J. Koenig, C.M. Peterson, R.L. Jones et al. //

Koranta ea New England eaMedicine. —1976. - Moq. 295, Che.8 - R. 417420.

4. Korolev V.A. Mokhoa oa Isoelectrofocusing le Photocolorimetry bakeng sa ho khetholla hemoglobin A1c / V.A. Korolev,

B.I. Khemik'hale ea Molchanov // Biomedical. - 2006. - T. 52, Che. -

5. Peters-Harmel E. Lefu la tsoekere: lefu la ho phekola le kalafo / E. Peters-Harmel, R. Matur: Trans. ho tsoa ho Senyesemane - M: Ho ikoetlisa, 2008 .-- 496 leq.

6. Mekhatlo ea Amerika ea Lefu la Ts'oaetso ea Lefu la Ts'oaetso ho lefu la tsoekere - 2010 // Tlhokomelo ea lefu la tsoekere. - 2010 .-- Moq. 33 (1). - P. 511-561.

7. Komiti ea machaba ea litsebi e tlaleha karolo ea papali ea Ac mabapi le lefu la lefu la tsoekere // Lefu la tsoekere. - 2009. - Moq. 32 (7). - P. 1327-1334.

8. Mokhoa o sebelisitsoeng oa tlhahlobo ea IFCC bakeng sa tekanyo ea HbAlc maling a motho // Clin. Khemo. Lab. Moedi - 2002. - Moq. 40 (1). - R. 78-89.

9. DCCT. Kamano ea ho pepesetsoa ha glycemic (HbAlc) kotsing ea kholo le ntlafatso ea retinopathy taolong ea lefu la tsoekere le mathata a lefu la tsoekere. - 1995. - Moq. 44 (8). - P. 968-983.

10. Stratton J.M. Mokhatlo oa glycaemia o nang le mathata a mangata a lefu la tsoekere la mofuta oa 2 (UKPDS 35): thuto e lebelletsoeng, thuto ea ho shebella / J.M. Stratton, A.I. Adler, A.W. Neil et al. // BMJ. - 2000. - Moq. 321. - P. 405-412.

11. Liphetho tsa Gnudi L. le tšusumetso ea ACCORD le ADVANCE / L. Gnudi // Mofuta oa lefu la tsoekere. - 2009. - Moq. 54, Che 1. - S. 29-32.

Kivsky Moscow 1 ^

MOLEMO OA HEMOGLOGUS O KHOLOGELENG HO DIAGNOSTICS LE TLHAHISO EA LITLHAKISO TSA KHOLO

Kakaretso Ka lefu la tsoekere la urachuvannyam le atileng ka bongata ba lefu la tsoekere, o ka nts'etsapele le ho potlakisa nts'etsopele ea ena, o motle haholo! Mathata a Yulkosp undiagnostic le ponelopele e seng kahare ho WHO. Ho na le litebello tse ngata tsa mellitus e atileng ea lefu la tsoekere ho SVT, e bohlokoa le e nepahetseng, tlhahlobo e nepahetseng ea ts'enyo ea semela sa carbohydrate. Glashanov haemoglobsh ke sesupo se lumellang maemo a tšoanang a mekhoa ho fana ka tsebiso ea boemo ba mabenyane a rekisoang ka tekanyo e kholo ea nako, mme o lumelloa hang-hang ho bona mefuta e senyehileng ea khabone. Ha ho ka etsahala hore ebe motho ea atlehileng ea nang le bothata ba "hemoglobe" e le sesupo sa tlhahlobo ea mafu, a fokolisa carbohydrate obschu kapa sethala sa tefo ea mellitus ea lefu la tsoekere, re bohlokoa ho feta mokhoa o nepahetseng oa ho thothometsa mokhoa oa ho khetholla letšoao lena ka mokhoa o ts'oanang! phahameng

Mantsoe a bohlokoa: lefu la tsoekere, glomerular hemoglobch, gl kuvannya, taolo ea glycemic.

Setsi sa Tleliniki ea Tlhabollo ea Masepala ea Kyiv, Kyiv, Ukraine

MOLEMO OA HEMOGLOBIN O NANG LE MOKHOA OA HO BONAHALA

Kakaretso Ha ho nahanoa ka bongata ba lefu la tsoekere le lefu la tsoekere, ho khonahala ha mathata a teng kapele le ka potlako, palo e kholo ea linyeoe tse sa lemohuoeng le tsoelo-pele e nyahamisang ea Mokhatlo oa Lefatše oa Bophelo mabapi le tebello ea lefu la tsoekere le tšoaetsanoang lefatšeng ka bophara, tlhahlobo e nepahetseng le e nepahetseng ea metabolism ea carbohydrate. litšila ke tsa bohlokoa. Hemoglobin ea glycated ke sesupo sa hore, ha e ntse e sebelisa mekhoa e emeng, e fana ka pono e kopaneng ea boemo ba glycemia nakong e telele ea nako mme e thusa ho bona ka nako mathata a carbohydrate metabolism. Ha o ntse o sebelisa hemoglobin ea glycated e le sesupo sa ho hlahloba mafu a amanang le carbohydrate metabolism kapa degree ea lefu la tsoekere ea mellitus, mokhoa o nepahetseng oa khetho ea mokhoa oa qeto ena ea index, o nahanne ka ho ts'epahala ha eona.

Mantsoe a bohlokoa: lefu la tsoekere, glycated hemoglobin, glycation, glycemic control.

Lits'oants'o tsa Tlhahlobo

Lisele tse khubelu tsa mali li na le hemoglobin A. Ke eena eo, ha e kopantsoe le glucose mme o kopana le liphetoho tse ngata tsa lik'hemik'hale, o fetoha hemoglobin ea glycosylated. Lebelo la "phetoho" ena le ipapisitse le lipontšo tsa tsoekere tse ngata nakong eo sele e khubelu ea mali e ntseng e phela. Nako ea bophelo ea lisele tse khubelu tsa mali e fihla ho matsatsi a 120. Ke nakong ena moo lipalo tsa HbA1c li baloang, empa ka linako tse ling, bakeng sa ho fumana liphetho tse nepahetseng haholo, ba tsepamisa maikutlo ho halofo ea bophelo ba lisele tse khubelu tsa mali - matsatsi a 60.

Mefuta e latelang ea glycosylated hemoglobin ke:

Ho ea ka lipalo-palo, boemo ba tlhatlhobo bakeng la letšoao lena ha bo fete 10% ea linyeoe tsohle tsa kliniki, tseo e seng 'nete bakeng sa tlhoko ea eona e amoheloang. Sena se bakoa ke tlhaiso-leseling e sa lekaneng ea bakuli ka boleng ba tlhahlobo ea tlhahlobo, tšebeliso ea bahlahlobisisi ba nkehang ba nang le tšibollo e tlase le palo e sa lekanang ea tlhahlobo sebakeng se itseng, e leng ho eketsang ho se tšepe ha litsebi tlhahlobong.

Ke mang ea filoeng tlhahlobo?

Taolo ha ea hlokahala bakeng sa lefu la tsoekere feela, empa le bakeng sa batho ba phetseng hantle ba tloaelanang le botenya le khatello ea mali. Ho hlahlojoa khafetsa ho bontšoa maemong a latelang:

• ho batho bohle kamora lilemo tse 45 (lilemo tse ling le tse ling tse 2-3, haeba liphetho tsa pele li ne li tloaelehile),
• bakuli ba nang le beng ka bona ba nang le lefu la tsoekere
• batho ba phelang bophelo ba ho lula fatše,
• tse nang le mamello ea tsoekere
• Basali ba nang le nalane ea lefu la tsoekere,
• basali ba nang le nalane ea macrosomia
• bakuli ba nang le polycystic ovary syndrome,
• bakuli ba nang le lefu la tsoekere mellitus (ea pele e khetholloang khahlano le semelo sa nts'etsopele ea mathata a hlobaetsang),
• le li-pathologies tse ling (ka lefu la Itsenko-Cushing, acromegaly, thyrotooticosis, aldosteroma).

Ho itokisetsa ho bokella boitsebiso ha ho hlokahale. Teko ea ho fumana qeto ea hemoglobin ea glycosylated ha e fuoe masea a fihlang ho isa ho likhoeli tse 6.

Melemo ea ho Tseba

Ho netefalitsoe ke lingaka hore lipatlisiso tse etsahalang khafetsa ho bakuli ba nang le lefu la tsoekere li fokotsa monyetla oa ho thatafala, kaha ho ka khona ho hlahloba le ho lokisa puseletso.

Ka foromo e itšetlehileng ka insulin, kotsi ea retinopathy e fokotsehile ka 25-30%, polyneuropathy - ka 35-40%, nephropathy - ka 30-35%. Ka foromo e ikemetseng ea insulin, kotsi ea ho ba le mefuta e fapaneng ea angiopathy e fokotsehile ka 30-35%, sephetho se bolaeang ka lebaka la mathata a "lefu lena le monate" - ka 25-30%, infraction ea myocardial - ka 10-15%, le lefu ka kakaretso - ka 3-5%. Ntle le moo, tshekatsheko e ka etsoa ka nako efe kapa efe, ho sa tsotelehe takatso ea lijo. Mafu a khahlang ha a ame boitšoaro ba thuto.

Tloaelo ea matšoao maling

Liphetho tsa bosholu ba laboraro bo se nang letho li ngotsoe ka%. Boleng ba kakaretso ba tloaelo le ts'ebetso ea methapo ea methapo ke tse latelang:

• ho fihla ho 5.7 - e bontša metabolism e ntle, ha e hloke mehato e eketsehileng,
• kaholimo ho 5.7, empa ka tlase ho 6.0 - ha ho na "lefu le monate", empa khalemelo ea lijo e ea hlokahala, hobane menyetla ea ho ba le lefu la tsoekere e phahame,
• kaholimo ho 6.0, empa ka tlase ho 6.5 - naha ea lefu la tsoekere kapa ts'ebetso ea mamello ea tsoekere.
• 6, 5 le kaholimo - tlhahlobo ea lefu la tsoekere e na le lipelaelo.

Matšoao a puseletso

Tlhahlobo ea katleho ea pheko ea mofuta oa 1 lefu la tsoekere ho latela hemoglobin ea glycated:

• ka tlase ho 6.1 - ha ho na lefu,
• 6.1-7.5 - kalafo e ea sebetsa,
• kaholimo ho 7.5 - ho haella ha katleho ea kalafo.

Mekhoa ea matšeliso bakeng sa maloetse a mofuta oa 1 le mofuta oa 2:

• ka tlase ho 7 - matšeliso (tloaelehileng),
• 7.1-7.5 - peeletso,
• kaholimo ho 7.5 - puseletso.

Kotsi ea ho ba le li-angiopathies khahlanong le semelo sa lefu la tsoekere la mofuta oa 2 ho latela lipontšo tsa HbA1c:

• ho fihla ho kenyeletsa 6.5 - kotsi e tlase,
• kaholimo ho 6.5 - kotsi e kholo ea ho holisa macroangiopathies,
• kaholimo ho 7.5 - kotsi e kholo ea ho nts'etsapele microangiopathies.

Laola khafetsa

Haeba lefu la tsoekere le fumanoa ka lekhetlo la pele, bakuli ba joalo ba fumanoa hang ka selemo. Ka khafetsa khafetsa, ba sa sebeliseng kalafo ea lithethefatsi bakeng sa "lefu le monate" ba hlahlojoa, empa ba batla puseletso ka kalafo ea ho ja le ho ikoetlisa hantle.

Tabeng ea ts'ebeliso ea li-agents tsa hypoglycemic, matšeliso a matle a hloka ho hlahloba matšoao a HbA1c hang ka selemo, le puseletso e mpe - hang kamora likhoeli tse tšeletseng. Haeba ngaka e laetse litokisetso tsa insulin, joale tlhahlobo molemong oa puseletso e ntle e etsoa ho tloha makhetlo a mabeli ho isa ho a mane ka selemo, ka tekanyo e sa lekaneng - makhetlo a 4 ka selemo.

Bohlokoa! Ho feta makhetlo a 4 ho tseba hore ha ho na bothata.

Lisosa tsa ho feto-fetoha ha maikutlo

Lenane le ntseng le eketseha la hemoglobin ea glycosylated ha le khone ho bonoa eseng feela ka "lefu le monate", empa hape le khahlano le maemo a latelang:

• hemoglobin e phahameng ho "masea" (boemo ke ba mmele mme ha bo hloke ho lokisoa),
• Ho fokotseha ha tšepe ea 'mele' meleng,
• Khahlano le bokantle ba ho tlosa lesapo la mokokotlo.

Ho fokotseha ha mahloriso a HbA1c ho etsahala maemong a joalo:

• nts'etsopele ea hypoglycemia (ho fokotseha ha tsoekere ea mali)
• hemoglobin e tloaelehileng,
• boemo kamora ho lahleheloa ke mali, ha ts'ebetso ea hematopoietic e sebetsoa,
• anemia hemolytic
• ho ba teng ha li-hemorrhages le ho tsoa hoa mali a bohloko haholo kapa a sa foleng,
• ho hloleha ha meno
• tšelo ea mali.

Mekhoa ea Boikarabello le Bahlahlobi

Ho sebelisoa mekhoa e 'maloa ho fumana li-indices tsa hemoglobin ea glycated; ka hona, ho na le bahlahlobisisi ba itseng bakeng sa mokhoa o mong le o mong oa tlhahlobo.

Khatello e phahameng ea ion exchange chromatography ke mokhoa oa ho arola ntho e rarahaneng ho likaroloana tsa motho ka mong, moo bohareng bo leng mokelikeli. Sebelisa bahlahlobisisi D 10 le Variant II. Teko e etsoa li-laboratories tse lipakeng tsa lipetlele tsa tikoloho le litoropo, litsi tsa tlhahlobo ea boemo bo tlase. Mokhoa o netefalitsoe ka botlalo mme o iketsahalla. Liphetho tsa tšoaetso ha li hloke tiiso e eketsehileng.

Immunoturbudimetry

Mokhoa oa ho hlahlobisisa o thehiloeng ho moralo oa li-antigen-antibody tsa khale. Karabelo e akaretsang e lumella sebopeho sa li-complexes tseo, ha li pepesoa le lintho tsa luminescent, li ka ikemisang tlas'a foto. Bakeng sa lipatlisiso, serum ea mali e sebelisoa, hammoho le lisebelisoa tse khethehileng tsa ho khetholla ho bahlahlobisisi ba biochemical ba ikatisang.

Patlisiso ea mofuta ona e ntse e etsoa ka lilaborator tsa biochemical tse nang le tlhahlobo ea mahareng kapa e tlase. Bothata ba mokhoa ona ke tlhoko ea ho hlophisoa ha sampole.

Chromatography e amanang

Mokhoa o ikhethang oa ho etsa lipatlisiso o thehiloeng tšebelisanong ea liprotheine tse nang le lintho tse ling tsa tlhaho tse eketsoeng tikolohong ea tlhaho. Bahlahlobi ba liteko - In2it, NycoCard. Mokhoa o u lumella ho fumana tšoaetso ka ho toba ofising ea ngaka (e sebelisoang linaheng tsa Europe).

Teko e sebelisoa maemong a ka thoko, e na le litšenyehelo tse phahameng tsa tse jang, ka hona ha ho tloaelehe ho li sebelisa. Tlhaloso ea sephetho e etsoa ke ngaka e neng e le teng ea laetseng thuto. Ho ipapisitsoe le matšoao a fumanoeng, maqheka a mang a taolo ea bakuli a khethoa.