Litaelo bakeng sa ts'ebeliso ea lithethefatsi, li-analogues, litekolo

Setlhare sena se hlahisitsoe ke biotechnology ea DNA e sebelisitsoeng hape se sebelisa mofuta oa Saccharomyces cerevisiae. Setlhare, se sebelisanang le li-receptor tse ikhethang tsa karolo ea kantle ea cytoplasmic ea sele, se theha motsoako oa "insulin" o thusang ts'ebetso kahare ho sele, ho kenyelletsa tlhahiso ea li-enzyme tsa bohlokoa (pyruvate kinase, hexokinase, glycogen synthetase le ba bang). Ho fokotseha ha tsoekere ea glucose maling ho hlaha ka lebaka la keketseho ea lipalangoang tsa eona ka har'a lisele, ho phahama le ho pepisoa ke lisele, le ho fokotseha ha sekhahla sa ho etsoa ha tsoekere maling. Setlhare se tsosa glycogenogeneis, lipogeneis, synthetiki.
Nako ea ts'ebetso ea lithethefatsi e haholo-holo ka lebaka la ho monya, ho latela tekanyetso, sebaka le tsela ea tsamaiso le lintlha tse ling, ketso ea ts'ebetso ea lithethefatsi e ka fapana haholo eseng ho bakuli ba fapaneng feela, empa le ho motho a le mong. Ka karolelano, ka tsamaiso e potolohang ea lithethefatsi, ho qala ha ts'ebetso ho bonoa ka mor'a lihora tse 1.5, phello e phahameng e fihlella ka mor'a lihora tse 4 ho isa ho tse 12, nako ea ts'ebetso e fihlile ho fihlela letsatsi. Ho qala ha phello le botlalo ba ho monya ha moriana ho latela tekanyetso (bokhutšoanyane ba moriana o laetsoeng), sebaka sa ente (thipa, mpa, mpa), ho kenella ka bongata ka har'a insulin, le lintlha tse ling. Khokahano e phahameng ea insulin ho plasma ea mali e fihlelloa nakong ea lihora tse peli ho isa ho tse 18 kamora ho tsamaisoa ha subcutaneous. Ha ho na polelo e tlamang ea liprotheine tsa plasma e boletsoeng, ntle le ha li potoloha li-antibodies ho insulin (haeba li teng). Sesebelisoa se tsamaisoa ka mokhoa o sa lekanang lithong tsohle, ha se kenelle ka lebeseng la mpa le ka sehikeng sa placental. Haholo-holo liphio le sebete, sethethefatsi se senngoa ke insulinase, hape, mohlomong, protheine disulfide isomerase. Li-metabolites tsa insulin ha li sebetse. Bophelo ba halofo ea insulin e tsoang maling ke metsotso e fokolang feela. Ho felisoa ha halofo ea bophelo ho tsoa ho ntho e phelang ho etsa hoo e ka bang lihora tse 5 - 10. E epolloa ke liphio (30 - 80%).
Ha ho na kotsi e ikhethang ea ts'ebeliso ea lithethefatsi ho batho e ileng ea senoloa nakong ea lithuto tsa preclinical, tse neng li kenyelletsa lithuto tsa chefo tse nang le tekanyetso e khutsitseng, lithuto tsa ts'ireletso ea meriana

Lefu la tsoekere la mofuta oa pele, lefu la tsoekere la mofuta oa bobeli: ho hanyetsa ka tsela e sa lekanyetsoang ho lithethefatsi tsa hypoglycemic (nakong ea phekolo e kopaneng), sethala sa ho hanyetsa lithethefatsi tsa hypoglycemic, mafu a kahare, lefu la tsoekere la mofuta oa bobeli ho basali baimana.

Mokhoa oa ts'ebeliso ea ntho ea bohlokoa ea insulin-isophan genetic engineering le doses

Setlhare se fanoa feela ka mokhoa o ikhethileng. Tekanyetso ntlheng e 'ngoe le e' ngoe e khethoa ke ngaka ka bonngoe e ipapisitse le phallo ea tsoekere maling, hangata tekanyetso ea letsatsi le letsatsi ea lithethefatsi e tloha ho 0.5 ho 1 IU / kg (ho latela boemo ba tsoekere ea mali le litšobotsi tsa motho ka mong). Ka tloaelo, sethethefatsi se kenngoa ka mokhoa o sa reng letho ka thipa. Hape, lithethefatsi li ka tsamaisoa ka mokhoa o sa ts'oaneng mokokotlong, bokantle ba mpa ea mpa le tikolohong ea mesifa e boreleli ea lehetla. Mocheso oa lithethefatsi tse tsamaisitsoeng o lokela ho ba ka mocheso oa kamore.
Se ke oa fana ka taolo ka kotloloho.
Tlhokahalo ea letsatsi le letsatsi ea insulin e ka ba tlaase ho bakuli ba nang le insulin ea tlhahiso ea insulin le ba phahameng ho bakuli ba hanyetsang insulin (ka mohlala, ho bakuli ba batenya nakong ea bokhachane).
Ho thibela nts'etsopele ea lipodystrophy, ho hlokahala hore u fetole sebaka sa ente ka hare ho sebaka sa anatomical.
Ha o sebelisa insulin, ho hlokahala hore kamehla a lekole ho kenella ha tsoekere maling. Ntle le tšebeliso e feteletseng ea lithethefatsi, lisosa tsa hypoglycemia e ka ba: ho tlōla lijo, ho tlosa lithethefatsi, lets'ollo, ho hlatsa, ho eketsa ts'ebetso ea mmele, ho fetola sebaka sa ente, mafu a fokotsang tlhoko ea insulin (ts'oaetso ea renal le "kapa" ts'ebetso ea sebete, pituitary gland pituitary, adrenal cortex, thyroid gland), ho sebelisana le lithethefatsi tse ling.
Ho robeha ho tsamaiso ea insulin kapa dosing e sa lokelang, haholo ho bakuli ba nang le lefu la tsoekere la 1, ho ka lebisa ho hyperglycemia. E le molao, matšoao a pele a hyperglycemia a hola butle, ho feta lihora tse 'maloa kapa matsatsi. Ho kenyelletsa ho ruruha ho eketsehileng, lenyora, ho nyekeloa, ho tsekela, ho hlatsa, ho omella le ho fifala ha letlalo, ho felloa ke takatso ea lijo, molomo o omileng, monko oa acetone moeeng o tsoang. Ntle le kalafo e khethehileng, hyperglycemia e ka lebisa nts'etsopele ea lefu la tsoekere la ketoacidosis, e leng bophelo bo kotsing.
Tekanyetso ea insulin e lokela ho fetoloa bakeng sa lefu la Addison, ts'ebetso ea qoqotho e senyehileng, ho senyeha ha renal le / kapa ts'ebetso ea sebete, hypopituitarism, tšoaetso le maemo a tsamaeang le feberu, ho feta lilemo tse 65. Hape, phetoho ea tekanyetso ea moriana e ka hlokahala haeba mokuli a fetola lijo tse tloaelehileng kapa a eketsa boikoetliso ba 'mele.
Setlhare se fokotsa mamello ea joala.
Pele ho leeto, le amanang le phetoho ea libaka, mokuli o lokela ho buisana le ngaka e tlang kaha ha a fetola nako ho bolela hore mokuli o tla kenya insulin mme a je lijo ka nako e 'ngoe.
Hoa hlokahala ho etsa phetoho ho tloha ho mofuta o mong oa insulin ho ea ho e 'ngoe tlas'a taolo ea khatello ea "glucose" maling.
Nakong ea ts'ebeliso ea lithethefatsi (haholo-holo bakeng sa morero oa pele, phetoho ea mofuta o mong oa insulin ho ea ho e 'ngoe, khatello ea maikutlo e kholo kapa ho ikoetlisa ka matla), bokhoni ba ho laola mekhahlelo e mengata, ho khanna koloi le ho etsa lintho tse ling tse ka bang kotsi tse hlokang lebelo la makoloi le karabelo ea kelello. le tlhokomelo e matla.

Bokhachane le pelehi

Ha ho na lithibelo tšebelisong ea insulin nakong ea kemolo le nakong ea kanyeso, hobane insulin ha e kene kahara placenta le ka lebese la matsoele. Hypoglycemia le hyperglycemia, tse ka ntlafatsang ka kalafo e khethiloeng ka mokhoa o sa lekanyetsoang, li eketsa kotsi ea lefu la fetal le ponahalo ea ho senyeha ha lesea. Bakhachane ba nang le lefu la tsoekere ba lokela ho ba tlhokomelong ea bongaka nakong eohle ea bokhachane ba bona, ba hloka ho lekola litekanyetso tsa tsoekere ea mali haholo, le likhothaletso tse tšoanang li sebetsa ho basali ba rerileng ho ima. Ka "trimester" ea pele ea bokhachane, tlhoko ea insulin hangata e fokotseha 'me butle-butle e eketseha ka trimesters ea bobeli le ea boraro. Kamora ho tsoala ngoana, hangata tlhoko ea insulin e khutlela kapele maemong a bonoang pele ho kemaro. Nakong ea kanyeso, basali ba nang le lefu la tsoekere ba ka hloka ho fetola mokhoa oa bona oa ho ja le / kapa litekanyetso.

Litla-morao tsa "insulin-isophan" ea tlhaho ea liphatsa tsa motho

Ka lebaka la phello ea metabolism ea carbohydrate: maemo a ho ferekanya kelello (ho fufuleloa ho eketsehileng, mofufutso, ho tepella, letlalo le pherese, pono e sa tsitsang, ho nyekeloa, ho tšoha, ho opeloa ke hlooho, ho tšoenyeha, ho ruruha, "presthesia" molomong, ho fokotsa khatello ea kelello ho tsepamisa maikutlo, ho ferekanya kelello, ho otsela, ho lahleheloa ke kelello, ho sithabela, ho senyeha ha nakoana kapa ho sa fetoheng hoa ts'ebetso ea boko, lefu), ho kenyelletsa le ho akheha ha hypoglycemic.
Litla-morao: lekhopho la letlalo, urticaria, edema ea Quincke, ho thothomela ha anaphylactic (ho kenyelletsa le letlalo le akaretsang, ho eketsa mofufutso, ho theola khatello ea mali, ho hlohlona, ho teneha ka mpeng, ho holofala, ho hema ka thata, ho phahamisa pelo, ho akheha / ho akheha).
Tse ling: liphoso tsa nakoana tse ntlafatsang (hangata qalong ea kalafo), bohloko ba methapo ea kutlo (neuropathy neuropathy), lefu la tsoekere le lefu la tsoekere.
Boitšoaro ba lehae: ho ruruha, ho ruruha, ho ruruha, hyperemia, bohloko, ho hlohlona, hematoma, lipodystrophy sebakeng sa ente.

Tšebelisano ea thepa insulin-isophan boenjiniere ba motho ba liphatsa tsa lefutso le lintho tse ling

: glucocorticoids, lithibela-pelehi tsa molomo, lihomone tsa qoqotho, heparin, thiazide diuretics, li-antidepressants tsa tricyclic, danazole, clonidine, sympathomimetics, calcium blockers, phenytoin, morphine, diazoxide, nikotini.
: Monoamine dihydrobenzophenanthridine inhibitors, molomo hypoglycemic lithethefatsi, angiotensin fetola inhibitors potlakisang tsebetso ea lik'hemik'hale, khetha beta-blockers, k'habone anhydrase inhibitors, octreotide, bromocriptine, sulfonamides, tetracyclines, anabolic steroid, clofibrate, mebendazole, ketoconazole, pyridoxine, cyclophosphamide, theophylline, lithethefatsi lithium fenfluramine.
Tlas'a tšusumetso ea li-salicylates, reserpine, litokisetso tse nang le ethanol, ka bobeli li fokolisa le ho ntlafatsa ketso ea insulin li ka khonahala.
Octreotide, lanreotide e ka eketsa kapa ea fokotsa tlhoko ea mmele ea insulin.
Beta-blockers li ka pata matšoao a hypoglycemia le ho hlaphoheloa butle butle ka mor'a hypoglycemia.
Ka tšebeliso e kopaneng ea lithethefatsi tsa insulin le thiazolidatedione, hoa khoneha ho ntshetsa pele ho nyeleha ha pelo ho sa feleng, haholo ho bakuli ba nang le mabaka a kotsi bakeng sa nts'etsopele ea eona. Ha kalafo e kopaneng joalo e laetsoe, ho a hlokahala hore ho hlahlojoe bakuli ho fumana ho hloleha ha pelo ho sa feleng, ho ba teng ha edema le ho nona. Haeba matšoao a ho hloleha ha pelo a mpefala ho bakuli, kalafo ea thiazolidatedione e lokela ho khaotsa.

Bongata

Ka moriana o feteletseng oa lithethefatsi, hypoglycemia ea hlaha.
Phekolo: mokuli a ka tlosa hypoglycemia e bonolo ka boeena, bakeng sa sena hoa hlokahala ho nka lijo tse nang le lik'habohaedreite tse ngata, kapa tsoekere kahare, ka hona ho khothalletsoa ho bakuli ba nang le lefu la tsoekere ho lula ba nkile tsoekere, likuku, liswiti, lero le le monate la litholoana. Ho hypoglycemia e matla (ho kenyelletsa ho lahleheloa ke kelello), tharollo ea 40% ea dextrose e tsamaisoa kahare, ka methapo, ka likhakanyo kapa kahare - glucagon. Kamora ho hlaphoheloa kelellong, mokuli o lokela ho nka lijo tse nang le lik'habohaedreite ho thibela tsoelopele ea hypoglycemia.

Thutela-litso

E sebetsana le li-receptor tse ikhethang tsa lera le ka ntle la cytoplasmic ea sele le ho theha motsoako oa "insulin-receptor" o kenyelletsang ts'ebetso ea methapo, ho kenyeletsa synthetise ea li-enzymes tse 'maloa tsa bohlokoa (hexokinase, pyruvate kinase, glycogen synthetase, jj.). Ho fokotseha ha tsoekere maling ho bakoa ke keketseho ea lipalangoang tsa eona tse ka hare, ho monya le ho monya ha li-tishu, le phokotso ea sekhahla sa tlhahiso ea tsoekere ke sebete. E susumetsa lipogenesis, glycogenogeneis, synthetic ea protheine.

Nako ea ts'ebetso ea litokisetso tsa insulin e haholoholoa ke tekanyo ea ho amoheloa ha motho, ho latela lintlha tse 'maloa (ho kenyelletsa le lethal dose, mokhoa le sebaka sa tsamaiso), ka hona boemo ba ts'ebetso ea insulin bo ka fetoha ka ho fokotseha hoa bohlokoa ho batho ba fapaneng, le ho e' ngoe motho a le mong. Ka karolelano, kamora ts'ebetso ea sc, ho qala hoa ts'ebetso ke kamora lihora tse 1.5, phello e kholo e ba teng pakeng tsa lihora tse 4 le 12, nako ea ts'ebetso e fihlile ho lihora tse 24.

Ho kenella ka botlalo le ho qala ha phello ea insulin ho itšetlehile ka sebaka sa ente (mala, thipa, buttocks), lethal dose (bophahamo ba insulin e kenang), khatello ea "insulin" lithethefatsing, joalo-joalo e ajoa ka mokhoa o sa lekanang lithong tsohle, mme ha e kenelle ka sekhahla sa placental le ho kena lebeseng la matsoele. E senngoa ke insulinase haholo-holo ka har'a sebete le liphio. E epolloa ke liphio (30-80%).

Litla-morao tsa ntho ena Insulin-isophan boenjiniere ba liphatsa tsa lefutso

Ka lebaka la phello ea metabolism ea carbohydrate: maemo a hypoglycemic (pallor ea letlalo, ho fufuleloa ho eketsehileng, palpitations, ho thothomela, tlala, ho ruruha, paresthesia molomong, hlooho e bohloko). Hypoglycemia e matla e ka lebisa ho hola ha mesifa ea hypoglycemic.

Litla-morao: ka seoelo - rash ea letlalo, edema ea Quincke, e sa tloaelehang haholo - ho ts'oaroa ha anaphylactic.

Tse ling: ho ruruha, liphoso tsa nakoana tse khothatsang (hangata qalong ea kalafo).

Boitšoaro ba lehae: hyperemia, ho ruruha le ho hlohlona sebakeng sa ente, ka tšebeliso ea nako e telele - lipodystrophy sebakeng sa ente.

Litlhokomelo bakeng sa thepa: Insulin-isophan engineering genetic engineering

Hoa hlokahala ho fetola sebaka sa ente kahare ho sebaka sa anatomical e le ho thibela nts'etsopele ea lipodystrophy.

Khahlano le semelo sa kalafo ea "insulin", ho hlokahala hore ho be le tlhaiso-leseling ea tsoekere ea mali kamehla. Lisosa tsa hypoglycemia, ho ekelletsa ho insulin e ngata, e ka ba: ho nkeloa sebaka ke lithethefatsi, ho tlola lijo, ho hlatsa, lets'ollo, ho eketsa ts'ebetso ea mmele, mafu a fokotsang tlhoko ea insulin (ts'ebetso ea sebete le ts'ebetso ea liphio, hypofunction ea adrenal cortex, pituitary kapa gland ea tšoelesa). liente, hammoho le ho sebelisana le lithethefatsi tse ling.

Ho se sebetse hantle kapa ho sitisoa ha tsamaiso ea insulin, haholo-holo ho bakuli ba lefu la tsoekere la mofuta oa 1, ho ka lebisa ho hyperglycemia. Hangata, matšoao a pele a hyperglycemia a fetoha butle-butle ka lihora tse ngata kapa matsatsi. Tsena li kenyelletsa lenyora, ho ruruha ho eketsehileng, ho nyekeloa, ho hlatsa, ho tsekela, ho redness le ho omella ha letlalo, molomo o omileng, ho felloa ke takatso ea lijo, monko oa acetone moeeng o tsoang. Haeba e sa phekoloe, hyperglycemia ea mofuta oa 1 lefu la tsoekere e ka lebisa nts'etsopeleng ea lefu la tsoekere le kotsi ea lefu la tsoekere.

Tekanyetso ea "insulin" e lokela ho fetoloa haeba ts'oaetso ea qoqotho e senyehile, lefu la Addison, hypopituitarism, lesapo le senyehileng la tšebetso ea liphio le lefu la tsoekere ho bakuli ba lilemo tse fetang 65. Ho fetola tekanyetso ea insulin ho ka hlokahala le haeba mokuli a eketsa matla a ho ikoetlisa kapa a fetola lijo tse tloaelehileng.

Maloetse a kopaneng, haholo-holo tšoaetso le maemo a tsamaeang le feberu, a eketsa tlhoko ea insulin.

Phetoho ea ho tsoa mofuteng o mong oa insulin o ea ho o mong e lokela ho etsoa tlasa taolo ea maemo a tsoekere ea mali.

Setlhare se theola mamello ea joala.

Mabapi le sepheo sa mantlha sa insulin, phetoho ea mofuta oa eona, kapa boteng ba khatello e kholo ea 'mele kapa kelello, hoa khoneha ho fokotsa bokhoni ba ho khanna koloi kapa ho laola mekhahlelo e mengata, hammoho le ho etsa lintho tse ling tse kotsi tse hlokang tlhokomelo e potlakileng le lebelo la karabelo ea kelello le koloi.

Litšobotsi tsa ntho eo Insulin-isophan engineering genetic engineering

Insulin e sebetsang lipakeng. Insulin ea motho e fumanoe a sebelisa theknoloji ea DNA e kopanyang.

E sebetsana le li-receptor tse ikhethang tsa lera le ka ntle la cytoplasmic ea sele le ho theha motsoako oa "insulin-receptor" o kenyelletsang ts'ebetso ea methapo, ho kenyeletsa synthetise ea li-enzymes tse 'maloa tsa bohlokoa (hexokinase, pyruvate kinase, glycogen synthetase, jj.).Ho fokotseha ha tsoekere maling ho bakoa ke keketseho ea lipalangoang tsa eona tse ka hare, ho monya le ho monya ha li-tishu, le phokotso ea sekhahla sa tlhahiso ea tsoekere ke sebete. E susumetsa lipogenesis, glycogenogeneis, synthetic ea protheine.

Video (tlanya ho bapala).

Tlhaloso ea ntho e sebetsang ea Insulin-isophan genetic engineering / Insulinum isophanum humanum biosynt syntum.

Foromo, lebitso la lik'hemik'hale: ha ho na data.
Sehlopha sa litloholo: lihormone le bahanyetsi ba tsona / insulin.
Ketso ea pharmacological: hypoglycemic.

Isofan insulin: litaelo tsa tšebeliso le theko ea lithethefatsi

Phekolo ea insulin e na le sebopeho, hobane mosebetsi oa mantlha oa kalafo ke ho lefella mathata a amanang le metabolism ea carbohydrate ka ho hlahisa moriana o khethehileng tlasa letlalo. Motsoako o joalo o ama 'mele hammoho le insulin ea tlhaho e hlahisoang ke manyeme. Maemong ana, kalafo e tletse kapa e na le leeme.

Har'a litlhare tse sebelisoang bakeng sa lefu la tsoekere, e 'ngoe e ntle ka ho fetisisa ke insulin Isofan. Setlhare sena se na le "insulin" ea enjene e entsoeng ka liphatsa tsa batho tsa nako e telele.

Sesebelisoa se fumaneha ka mefuta e fapaneng. E tsamaisoa ka mekhoa e meraro - ka mokhoa o ikhethileng, ka mokhoa o ts'oanang le kahare. Sena se lumella mokuli hore a khethe khetho e ntle ka ho fetisisa ea ho laola boemo ba glycemia.

Matšoao a sebelisang le mabitso a khoebo ea lithethefatsi

Tšebeliso ea lithethefatsi e bontšoa mofuta oa lefu la tsoekere le itšetlehileng ka insulin. Ho feta moo, kalafo e lokela ho ba bophelo bohle.

Insulin e le Isofan ke lithethefatsi tse entsoeng ka liphatsa tsa lefutso tsa motho tse hlalositsoeng maemong a joalo:

mofuta oa 2 lefu la tsoekere (le itšetlehileng ka insulin),
mekhoa ea ho buoa
ho hanyetsa li-agents tsa hypoglycemic tse nkiloeng ka molomo e le karolo ea kalafo e rarahaneng,
lefu la tsoekere (ge ho sa sebelisoe katleho ea kalafo ea ho ja),
psychologist

Likhamphani tsa meriana li hlahisa insulin ea tlhaho ea motho tlasa mabitso a fapaneng. Tse tummeng ke Vozulim-N, Biosulin-N, Protafan-NM, Insuran-NPH, Gensulin-N.

Mefuta e meng ea isofan insulin e boetse e sebelisoa ka mabitso a latelang a khoebo:

Boholo
Humulin (NPH),
Pensulin,
Isofan insulin NM (Protafan),
Actrafan
Insulidd N,
Biogulin N,
Protefifi ea Protafan-NM.

Ke habohlokoa ho hlokomela hore tšebeliso ea lebitso leha e le lefe la insulin Isofan le lokela ho lumellanoa le ngaka.

Insulin ea motho e na le phello ea hypoglycemic. Setlhare se kenella le li-receptor tsa membrane ea sele ea cytoplasmic, e etsa mochini o nang le insulin-receptor. E kenya ts'ebetsong lits'ebetso tse etsahalang kahare ho lisele mme e kopanya li-enzymes tsa mantlha (glycogen synthetase, pyruvate kinase, hexokinase, jj.).

Ho theola khatello ea tsoekere ho etsoa ka ho eketsa sephethe-phethe sa eona, ho theola sekhahla sa tlhahiso ea tsoekere ke sebete, ho khothaletsa ho monya le ho monya tsoekere e eketsehileng ka lithishu. Hape, insulin ea motho e kenya ts'ebetsong liprotheine, glycogenogeneis, lipogeneis.

Nako ea ts'ebetso ea moriana e itšetlehile ka lebelo la ho monya, mme e bakoa ke lintlha tse fapaneng (sebaka sa tsamaiso, mokhoa le lethal dose). Ka hona, katleho ea "insulin" ea insulin e ka ba likhohola ho mokuli a le mong le balemi ba bang ba lefu la tsoekere.

Hangata kamora ho ente, phello ea lithethefatsi e bonoa kamora lihora tse 1.5. Tlhōrō e phahameng ka ho fetisisa ea katleho e etsahala lihoreng tse 4-12 kamora tsamaiso. Nako ea ketso - letsatsi le le leng.

Kahoo, botlalo ba ho monya le ho qala ha ts'ebetso ea moemeli ho latela lintlha tse kang:

sebaka sa ente (lesoba, serope, mpa),
ntho e sebetsang
litekanyetso.

Litokisetso tsa insulin ea motho li ajoa ka mokhoa o sa lekanang liseleng. Ha li kenelle ka har'a placenta ebile ha li kenngoe lebese la matsoele.

Li senngoa ke insulinase haholo maling le lipong, e pepesitsoeng ka bongata ba 30-80% ka liphio.

Litaelo tsa ts'ebeliso ea insulin Isofan e re hangata e tsamaisoa ka mokhoa o ikhethileng ho fihlela makhetlo a 2 ka letsatsi pele ho lijo tsa hoseng (metsotso e 30-45). Maemong ana, o hloka ho fetola sebaka sa ente letsatsi le leng le le leng 'me u boloke syringe e sebelisitsoeng mochesong oa kamore, le e ncha sehatsetsing.

Ka linako tse ling sethethefatsi se tsamaisoa ka mokhoa o kopaneng. Mokhoa o kenang ka matla oa ho sebelisa insulin e etsang lintho tse mahareng ha o sebelisoe.

Litekanyetso li baloa ka kotloloho ho mokuli e mong le e mong, ho ipapisitsoe le boemo ba tsoekere ea tsoekere mehloling ea likokoana-hloko le hore na lefu lena le sebetsa hakae. E le molao, litekanyetso tse tloaelehileng tsa letsatsi le letsatsi li tloha ho 8-24 IU.

Haeba bakuli ba le hypersensitivity ho insulin, joale palo e nepahetseng ea letsatsi le letsatsi ea lithethefatsi ke 8 IU. Ka ts'oaetso e mpe ea li-hormone, litekanyetso li eketseha - ho tloha ho 24 IU ka letsatsi.

Ha bophahamo ba letsatsi le letsatsi ba lithethefatsi bo feta 0,6 IU ka kilo e le 'ngoe, joale liente tse peli li etsoa likarolong tse fapaneng tsa' mele. Bakuli ba nang le tekanyetso ea letsatsi le letsatsi ea 100 IU kapa ho feta ba lokela ho kena sepetlele haeba insulin e nkeloa sebaka.

Ho feta moo, ha ho fetisoa ho tloha ho mofuta o mong oa sehlahisoa ho ea ho se seng, ho hlokahala hore ho be le leihlo la tsoekere.

Tšebeliso ea insulin ea motho e ka baka lipontšo tsa mafu. Hangata, ke angioedema (hypotension, phefumoloho, feberu) le urticaria.

Hape, ho feta tekanyetso ho ka lebisa ho hypoglycemia, ho bonahatsoang ke matšoao a latelang:

ho hloka boroko
letlalo blancing,
khatello ea maikutlo
hyperhidrosis
tshabo
mmuso o thabileng
palpitations
hlooho e bohloko
pherekano,
mathata a vestibular
tlala
thothomelo le lintho.

Litla-morao li kenyeletsa lefu la tsoekere le hyperglycemia, e bonahatsoang ke ho tjebela sefahleho, ho otsela, takatso e fokolang ea lijo le lenyora. Hangata, maemo a joalo a hlaha khahlano le semelo sa mafu a tšoaetsanoang le feberu, ha ente e lahlehile, litekanyetso li fosahetse, mme haeba lijo li sa lateloe.

Ka linako tse ling ho etsahala hore motho a be le letsoalo. Maemong a thata, ho hlaha boemo bo botle le bo soabisang.

Qalong ea kalafo, ho ka ba le mathata a nakoana mesebetsing ea pono. Keketseho ea karolo ea litopo tsa anti-insulin e boetse e lemohuoa ka ho eketseha ho tsoelang pele ha glycemia le karabelo ea immunological ea sebopeho se nang le insulin ea motho.

Khafetsa sebaka sa ente se ea ruruha le ho hlohlona. Tabeng ena, li-hypertrophies kapa li-atrophies tse ka tlas'a mafura. Boemong ba pele ba kalafo, ho ka hlaha liphoso tsa nakoana tse khothatsang le edema.

Haeba ho na le lithethefatsi tse ngata tsa li-hormone, tsoekere ea mali e theoha haholo. Sena se baka hypoglycemia, 'me ka linako tse ling mokuli o oa o akheha.

Haeba tekanyetso e fetisitsoe hanyane, o lokela ho nka lijo tse nang le carb e ngata (chokolete, bohobe bo tšoeu, moqolo, lipompong) kapa ho noa seno se se monate haholo. Maemong a ho hlohlona, tharollo ea dextrose (40%) kapa glucagon (s / c, v / m) e fuoa mokuli ho / ka.

Ha mokuli a hlaphoheloa, ho hlokahala hore a mo fepe lijo tse nang le lik'habohaedreite tse ngata.

Sena se tla thibela ho khutla ha hypoglycemic le komello ea glycemic.

Ho emisoa bakeng sa tsamaiso ea sc ha ho sebelisoe ka tharollo ea lithethefatsi tse ling. A sebedisana tsamaiso le sulfonamides, Ace / Mao / k'habone anhydrase, NSAIDs, ethanol inhibitors, anabolic steroid, chloroquine, androgens, quinine, bromocriptine, pirodoksin, tetracyclines, litokisetso lithium, clofibrate, fenfluramine, Ketonozolom, Tsiklofosvamidom, theophylline, mebendazole natefisa hypoglycemic sebediswa.

Ho fokola ha ts'ebetso ea hypoglycemic ho kenya letsoho ho:

H1 histamine receptor blocker,
Glucagon
Somatropin
Epinephrine
GKS,
Phenytoin
lithibela-pelehi tsa molomo
Epinephrine
Mahlaba
calcium antagonists

Ntle le moo, ho fokotseha ha tsoekere ho baka tšebeliso e kopanetsoeng ea Isofan insulin e nang le loop le thiazide diuretics, Klondin, BMKK, Diazoxide, Danazol, lihormone tsa qoqotho, li-antidepressants tsa li-tricyclic, li-sympathomimetics, Heparin le sulfinpyrazone. Nikotine, matekoane le morphine le tsona li eketsa hypoglycemia.

Pentamidine, beta-blockers, Octreotide le Reserpine li ka ntlafatsa kapa tsa fokolisa glycemia.

Litlhokomelo tsa tšebeliso ea insulin ea Isofan ke hore motho ea nang le lefu la tsoekere o lokela ho lula a fetola libaka moo ente ea insulin e tla fuoa. Ntle le moo, tsela feela ea ho thibela ponahalo ea lipodystrophy.

Khahlano le semelo sa kalafo ea "insulin", o hloka ho beha leihlo tsoekere e ngata khafetsa. Ho joalo, ho ena le tšebelisano-'moho le lithethefatsi tse ling, lintlha tse ling li ka baka hypoglycemia:

lefu la tsoekere le ho hlatsa,
phetiso ea lithethefatsi
ho eketsa mmele
maloetse a fokotsang tlhoko ea "hormone" (renal le ho hloleha ha sebete, hypofunction ea tšoelesa ea qoqotho, pituitary gland, jj.),
jang lijo tse sa reroang,
phetoho ea sebaka sa ente.

Tekanyetso e sa nepahalang kapa ho ema hanyane pakeng tsa ente ea insulin ho ka kenya letsoho kholisong ea hyperglycemia, haholo-holo ka lefu la tsoekere la mofuta oa 1. Haeba phekolo e sa fetoloe ka nako, ka nako e 'ngoe mokuli o ba le komello ea ketoacidotic.

Ntle le moo, phetoho ea tekanyetso ea hlokahala haeba mokuli a le kaholimo ho lilemo tse 65, o sitisitse ts'ebetso ea tšoelesa ea qoqotho, liphio kapa sebete. Ho hlokahala hape bakeng sa hypopituitarism le lefu la Addison.

Ho feta moo, bakuli ba lokela ho tseba hore litokisetso tsa insulin ea motho li fokotsa mamello ea joala. Mehatong ea pele ea kalafo, ha ho ka etsoa pheko, maemo a sithabetsang, ho ikoetlisa ka matla, ha ho hlokahale ho khanna koloi le mekhoa e meng e rarahaneng kapa ho etsa lintho tse ka bang kotsi tse hlokang hore ho be le khatello e eketsehileng le lebelo la karabelo.

Bakuli ba baimana ba lokela ho nahana hore ka nako ea pele trimester tlhoko ea insulin e ea fokotseha, 'me ho 2 le 3 e ea eketseha. Hape, palo e nyane ea hormone e ka hlokahala nakong ea mosebetsi.

Litšobotsi tsa pharmacological tsa Isofan li tla tšohloa videong ena.

Lefu la tsoekere - M: Bongaka, 1964 - 603 leq.
Maloetse a Rudnitsky L.V. Phekolo le thibelo, Peter - M., 2012. - 128 c.
Kennedy Lee, Basu Ansu Diagnosis le kalafo ho endocrinology. Mokhoa o nang le mathata, GEOTAR-Media - M., 2015. - 304 leq.

E re ke itsebise. Lebitso la ka ke Elena. Ke qetile lilemo tse fetang 10 ke sebetsa ke le setsebi sa endocrinologist. Ke lumela hore hajoale ke setsebi lebaleng la ka mme ke batla ho thusa baeti bohle ba sebakeng sa marang-rang ho rarolla mesebetsi e rarahaneng eseng joalo. Lisebelisoa tsohle tsa sebaka sena sa marang-rang li bokelloa ebe li sebetsoa ka hloko e le hore li fetise litaba tsohle tse hlokahalang ka hohle kamoo ho ka khonehang. Pele o sebelisa se hlalosoang webosaeteng, ho hlokahala tumellano ea ho buisana le litsebi kamehla.

Litaelo tsa ho sebelisoa

Litaelo tsa tšebeliso li totobatsa mofuta oa mantlha oa lefu leo ho lona ho sebelisoang insulin e entsoeng ka liphatsa tsa lefutso - mellitus e itšetlehileng ka lefu la tsoekere. Phekolo maemong ana e etsoa bophelo bohle. Tabeng ena, ho bohlokoa ho latela mohlala oa ente. Ntle le moo, Isofan e sebelisetsoa lefu la tsoekere la mofuta oa 1 le mofuta oa 2.

Ngaka e ka u fa moriana haeba ho e-na le ho haella ha litlamorao ho tsoa ho meriana e nang le phello ea ho fokotsa tsoekere. Ebe insulin e fanoa e le kalafo e kopanyang.

Keketseho ea tsoekere ea mali le eona e ka ba sesosa sa mathata, ho etsa mohlala, kamora ho buuoa. Maemong ana, insulin le eona e ka fanoa e le kalafo e rarahaneng. E ngoletsoe basali baimana ba nang le lefu la tsoekere.

Isofan e sebelisoa feela bakeng sa lefu la tsoekere la mofuta oa 1 le mofuta oa 2!

Setlhare sena se kopantsoe le ho bakuli ba tloaetseng ho etsa lintho tse ling hape ba nang le hypoglycemia.

Phello ea maikutlo

Litlamorao tse kholo tsa ho nka Isofan ke:

Litholoana tse mpe tsa metabolism ea carbohydrate. Sena se bontšoa ka mokhoa oa pallor ea letlalo, ho fufuleloa haholo, ho otla ha pelo ka potlako, ponahalo ea ho thothomela, motho o lula a batla ho ja, a ikutloa a hlasimolohile, a opeloa ke hlooho khafetsa.
Allergy e hlahisoang ke lekhopho la letlalo, edema ea Quincke. Maemong a sa tloaelehang, lithethefatsi li baka ho ts'oaroa ha anaphylactic.
Ho hlaha ho ka hlaha.
Kamora ho ente, ho hlohlona kapa ho ruruha, ho longoa ho ka ba teng. Haeba kalafo e nka nako e telele, ho etsoa lipodystrophy.

Ntlheng ena, qalong ea kalafo, kalafo ea insulin e ka etsoa feela kamora ho khethoa ha ngaka le tlasa taolo ea hae.

Tekanyetso e fetelletseng

Tabeng ea ho kenyelletsa lethal dose le ntseng le eketseha la moriana, mokuli a ka ba le matšoao a hypoglycemia. Maemong ana, o hloka ho ja sengoathoana sa tsoekere kapa lijo tse nang le lik'habohaedreite tse ngata. E ka ba li-cookies, lero la litholoana, liswiti.

Ho tsebisa Isofan haholo ho ka etsa hore o lahleheloe ke tsebo. Ho khothalletsoa hore o fane ka ente ea intravenous ea tharollo ea 40% ea dextrose. Glucagon e ka tsamaisoa ka methapo, kahare kapa ka letsoho.

Tšebelisano

Litaelo tsa tšebeliso ea lithethefatsi li hlalosa ka botlalo litšobotsi tsa lithethefatsi le menyetla ea tšebeliso ea lona.

Boenjiniere ba lefutso ba motho ba Isofan bo sebetsa haholoanyane ha lithethefatsi tse latelang li nkuoa ka nako e le 'ngoe:

Hypoglycemic melomo ea molomo.
Mae inhibitors a MAO le ACE, anidrase ea khase.
Sulfonamides.
Anabolikov.
Tetracyclines.
Motsoako o nang le ethanol.

Katleho ea Isofan e fokotseha ka ts'ebeliso ea: lithibela-pelehi tsa molomo, lithethefatsi tsa glucocorticoid, lihormone tsa qoqotho, li-antidepressants, morphine. Haeba ho sa khonehe ho hlakola lithethefatsi tse amang ketso ea insulin, ho bohlokoa ho lemosa ngaka e eang ka sena.

Lithethefatsi tse tšoanang

Bakuli ba lefu la tsoekere ba thahasella potso ea hore na ho na le mekhoa e ka nkelang insulin sebaka. Ho khothalletsoa ho sebelisa li-analogues tse latelang tsa Isofan bakeng sa kalafo: Humulin (NPH), Protafan-NM, Protafan-NM Penfill, Insumal, Actrafan.

Pele u fetola Isofan ho analog, ho hlokahala hore u buisane le ngaka ea hau. Phekolo ea insulin ke kalafo e tebileng. E hloka taeo holima mokuli le ho elelloa ke ngaka.