Glucose ea mali: tloaelehileng, mefuta ea lithuto, mokhoa oa ho itokiselletsa tlhahlobo
Sekhahla sa tsoekere ea mali ho basali le banna ke 3.3-6.1 mmol / l. Ho kheloha ha nako e telele le / kapa halelele ho ka bontša nts'etsopele ea li-pathologies, haholo-holo hypoglycemia le hyperglycemia.
Glucose ke karolo e ka sehloohong ea 'mele. Lik'habohaedreite tse nooang li felisitsoe tsoekere e bonolo, e kenngoeng ke mala a manyane ebe e kena maling. Ka mali, tsoekere e atoloha ho pholletsa le 'mele, e fana ka matla a mesifa. Tlas'a tšusumetso ea eona, tlhahiso ea insulin, e leng hormone ea manyeme, e khothalletsa ho fetisoa ha tsoekere ka seleng, e boloka boemo bo itseng ba tsoekere maling le ts'ebeliso ea eona. Sebete, lisele tse ngata haholo, lihormone tse ling li kentse letsoho ho boloka phallo ea tsoekere maemong a ka hare a 'mele.
Tekanyo ea tsoekere ea 7.8-11 ke tloaelo bakeng sa lefu la tsoekere, keketseho ea letšoao le kaholimo ho 11 mmol / l e bontša lefu la tsoekere.
Hobaneng u tseba tsoekere
Ka mokhoa o tšoanang, tsoekere ke mohloli oa matla bakeng sa lisele tse ngata tsa 'mele. Ka lebaka la ho ba teng ha glucose liseleng tsa 'mele oa motho, lits'ebetso tse ngata tsa bohlokoa li etsahala. Glucose e kena 'meleng ea rona ka lijo tse jeoang, ka lebaka leo, ka lebaka la insulin (ntho e sebetsang e patiloeng ke lisele tsa manyeme), e kenella ka har'a metsoako e bonolo ea lik'hemik'hale' me e kena maling. Ka tloaelo, motho o na le ho its'epahalla: a amohela glucose = "insulin" e hlahisitsoeng. Le lefu la tsoekere, morero ona oa tlotsoa. Haeba motho a e-na le matšoao a latelang, ho hlokahala hore ho etsoe tlhahlobo ea mahala ho tseba hore na glucose e maling e kae. Matšoao
- Lenyora le leholo la molomo o omileng.
- Ho ntša metsi kapele.
- Bofokoli bo akaretsang bo nang le ho hlonama khafetsa.
- "Monko" oa acetone e tsoang molomong.
- Lipelo tsa pelo.
- Boteng ba botena.
Tlolo ea litho tsa pono. Ho khetholla boemo ba tsoekere maling ho etsa hore ho khonehe ho belaella nts'etsopele ea lefu la tsoekere ka nako e loketseng, khetha mofuta o nepahetseng oa kalafo, le ho lokisa kalafo nakong ea kalafo. E lumella mokuli, ka boleng ba moeli (moeli o tlase oa "glucose" e tlase), ho fetola e 'ngoe ea lisosa tsa tsoekere bakeng sa bokamoso bo phetseng hantle. Hangata, mabaka a behang batho kotsing ea lefu la tsoekere ke lefutso, mokhoa oa bophelo le liphetoho tse amanang le lilemo.
Ho itokisetsa mamello
Bakeng sa lipatlisiso, mali a tsoang mothapo le monoana o loketse. Tlhahlobo e etsoa ka mpeng e se nang letho maemong a khutsitseng. Pele o fana ka mali, o tlameha ho khaotsa ho sebelisa moriana. Kahoo ho bohlokoa hore ka le hlahlamang u kenyeletse tšebeliso ea lik'habohaedreite, phofo le lijo tse "monate" (bohobe bo tšoeu, bijoux, lino tse khabisitsoeng ka khabone, lino tse fapaneng, confectionery, jj.
Ts'ebetso
Tlhahlobo e etsoa ke baoki ba fanang ka thuso ea bongaka maemong a tšohanyetso ba sebelisa mekhoa e fapaneng. Mokhoa o mong o tloaelehileng ke glucose oxidase le kinetic. Ka mantsoe a bonolo, molao-motheo oa mokhoa o ipapisitse le ho fumana sebaka sa ho monya (tsoekere le reagent), se behang tlhahlobo ea biochemical. Ho bohlokoa ho hlokomela hore ho khethoa ha tsoekere ho lihlahisoa tsa biochemical, mali a venous (mali a retelehileng) a khethoa. Mali a capillary hangata a hlahlojoa lisebelisoa tse khethehileng ("glucose"). Li-glucometer tse nkehang li tsebahala haholo, moo ho hlokahalang tlhahlobo - 'mela le lerotholi la mali a mokuli ho tsoa monoaneng. Ebe kamora metsotsoana e seng mekae, khatello ea tsoekere maling a "capillary" e bontšoa ponts'ong ea mita.
Keketseho le ho fokotseha ha tsoekere
Keketseho ea kokoana-hloko:
- Ka maloetse a thyro le manyeme.
- Le lefu la tsoekere.
- Ka oncological pathology ea manyeme.
- Ka mafu a liphio, sebete.
Ho theoha ha glucose:
- Pathology ea manyeme, moo ho nang le tlolo ea tlhahiso ea insulin.
- Ka tlolo ea tlhahiso ea li-hormone tsa pituitary (karolo ea boko).
- Pherekano ea pancreatic.
- Ho nka meriana.
- Bongata ba insulin.
Thibelo
"Ho bonolo ho thibela mafu ho fapana le ho a phekola" - polelo ena, e loketse tšireletso ea lefu la tsoekere. 'Me thibelo ea lefu la tsoekere e amahanngoa le boikemisetso ba nako ea phepelo ea glucose le hemoglobin ea glycated. Ka lehlohonolo, batho ba bangata lefats'eng ba sebelisa haholo methapo ea tsoekere ea mali, e thusang batho, haholo ba nang le lefu la tsoekere, ho tseba boemo ba bona ba tsoekere hantle.
Glucose ea mali
Ho fumana maemo a tsoekere ea mali, joalo ka tlhahlobo e akaretsang ea mali, ke e 'ngoe ea liteko tse tloaelehileng tsa laboratori. Mefuta ea glucose e ka hlahlojoa ka thoko kapa nakong ea tlhahlobo ea mali e nang le biochemical. Mali bakeng sa glucose a ka nkuoa ho tloha monoaneng kapa mothapong. Tloaelo ea tsoekere maling a capillary ho batho ba baholo ke 3.3-5,5 mmol / l, ka venous - 3.7-6.1 mmol / l, ho sa tsotelehe bong. Tekanyo ea tsoekere ea 7.8-11 ke tloaelo bakeng sa lefu la tsoekere, keketseho ea letšoao le kaholimo ho 11 mmol / l e bontša lefu la tsoekere.
Teko ea mamello ea glucose
Teko ea mamello ea glucose ka mojaro - makhetlo a mararo a khatello ea tsoekere ka nako e telele kamora mojaro oa carbohydrate. Nakong ea thuto, mokuli o nka sampole ea mali ea venous ea pele, e khethollang boemo ba pele ba tsoekere. Ebe ba ithaopela ho noa tharollo ea tsoekere. Kamora lihora tse peli, sampole ea mali e tsoang mothapong e boetse e nkuoa hape. Tlhahlobo e joalo e senola ho se mamellehe ha glucose le mathata a morao-rao a carbohydrate metabolism.
Ho nkoa e le ntho e tloaelehileng haeba ho se na tsoekere e fetang 5.5 mmol / L ea glucose karolong ea mali e potlakileng, 'me ka mor'a lihora tse peli - ka tlase ho 7.8 mmol / L. Letšoao la 7.8-11.00 mmol / L kamora ho ts'oaroa tsoekere le bonts'a mamello e tsitsitseng ea tsoekere le prediabetes. Lefu la tsoekere le fumanoa haeba palo ea tsoekere karolong ea pele ea mali e feta 6.7 mmol / L, 'me ea bobeli - 11.1 mmol / L.
Teko ea mamello ea glucose nakong ea kemolo
Ho ntse ho etsoa thuto ea ho fumana lefu la tsoekere. Liphetoho tsa 'mele nakong ea kemaro li ka lebisa tlolong ea metabolism ea carbohydrate, ha kholo ea placenta, khanyetso ea insulin e eketseha. Tekanyo e tloaelehileng ea "glycemia" ea fetoha nakong ea letsatsi nakong ea kemolo, ka bongata ba 3.3-6.6 mmol / l.
Hypoglycemia e kenyelletsa matla a ho bolaoa ke tlala ea lisele, tse sitisang ts'ebetso e tloaelehileng ea 'mele.
Teko ea mamello ea glucose nakong ea kemolo e etsoa ka mekhahlelo e 'meli. Phuputso ea pele e tlamang ke basali bohle ba bakhachane ho isa libekeng tse 24. Boithuto ba bobeli bo etsoa bekeng ea 24-28 eaimana. Tabeng ea mats'oao a ho hlatsuoa ha lesea ka popelong, ho na le lintho tse kang glucosuria, botenya, lefu la esale pele la lefu la tsoekere, nalane ea lefu la tsoekere la bongaka, tlhahlobo e etsoa pejana - ka libeke tse 16-18. Ha ho hlokahala, o khethoa hape, empa ha ho fetile beke ea 32.
Ho hlapolla glucose le tharollo ea bokae eo u e hlokang? Glucose ka mokhoa oa phofo e hlapolotsoe ka 250-300 ml ea metsi. Haeba tlhahlobo e le lihora tse tharo, joale nka 100 g ea tsoekere, bakeng sa boithuto ba lihora tse peli, palo ea eona ke 75 g, bakeng sa tlhahlobo ea nako e telele - 50 g.
Bakeng sa basali ba baimana, keketseho e nyane khubung ea tsoekere maling maling ka mor'a hore ho jeoe tšobotsi, ha e ntse e le tloaelehileng ka mpeng e se nang letho. Keketseho ea tsoekere ea mali ho mosali oa moimana ea se nang lefu la tsoekere, hora e le 'ngoe ka mor'a ho nka mojaro ha ea lokela ho feta 7.7 mmol / L. Lefu la tsoekere la lefu la sethoathoa le fumanoa haeba tekanyo ea tsoekere ho sampole ea pele e feta 5.3 mmol / L, kamora hora e ne e phahame ho feta 10 mmol / L, kamora lihora tse 2 e ne e feta 8,6 mmol / L, kamora lihora tse 3 e feta 7.7 mmol / L.
Glycated Hemoglobin Assay
Boikemisetso ba hemoglobin ea glycated (e bonts'itsoe ka foromo ea tlhahlobo - HbA1c) - boikemisetso ba glucose e tloaelehileng ea mali ka nako e telele (likhoeli tse 2-3). Teko eu lumella ho supa lefu la tsoekere ho tloha qalong, lekola ts'ebetso ea kalafo, fumana hore na matšeliso a lefu lena ke a mofuta ofe.
Hyperglycemia ke sesupo sa metabolism e sa foleng ea carbohydrate, e bontša nts'etsopele ea lefu la tsoekere kapa mafu a mang a tsamaiso ea endocrine.
Tekanyo ea hemoglobin ea glycated e tsoa ho 4 ho isa ho 6%. Tekanyo ea glycation ea hemoglobin e phahame haholo, ha tsoekere e ngata maling. Haeba tsoekere ea mali e le pakeng tsa 6 ho isa ho 6,5%, re bua ka prediabetes. Letšoao le kaholimo ho 6.5% le supa lefu la tsoekere, keketseho ea ho fihlela ho 8% kapa ho feta le lefu la tsoekere le netefalitsoeng le bonts'a katleho e sa lekanang ea kalafo. Tekanyo e ntseng e eketseha ea glycation e ka etsahala le ka ho se sebetse hantle ha renal, khaello ea methapo ea mali, mafu a pancreatic, kamora splenectomy. Ho fokotseha ha hemoglobin ea glycated ka tlase ho 4% ho ka supa insuloma, ho haella ha adrenal, mmuso ka mora tahlehelo ea mali, ts'ebeliso e feteletseng ea li-hypoglycemic agents.
Boikemisetso ba ceptide
Teko ea mali ka tlhaloso ea C-peptide ke tlhahlobo e khethollang mofuta oa 1 le mofuta oa 2 lefu la tsoekere, tlhahlobo ea tšebetso ea lisele tsa beta li hlahisang insulin ea tsona. Tloaelo ea C-peptide ke 0.9-7.1 ng / ml. Keketseho ea eona ea mali e bonoa ka mofuta oa "mellitus" oa tsoekere o sa ts'epheng insulin, insulinoma, ho hloleha ha methapo, kankere ea hlooho ea pancreatic, kamora ho fetisoa ha of-lisele tsa manyeme. Ho fokotseha ha C-peptide maling ho ka bontša mofuta oa tsoekere 1 lefu la tsoekere, hypoglycemia ka lebaka la tsamaiso ea insulin, joala bo matla ba joala le ho ba teng ha li-antibodies ho li-insulin receptor.
Qeto ea boemo ba lactate
Boikemisetso ba boemo ba mahloriso ba lactic acid (lactate) maling bo etsoa e le ho lekola kotsi ea lactic acidosis, mathata a lefu la tsoekere. Tloaelo ea lactate maling a motho e moholo e fapana ho tloha ho 0.5-2 mmol / l, ho bana letšoao lena le phahame. Ka bohlokoa ba tleliniki ke keketseho feela ea tlhahiso ea lactate. Boemo boo ka bona bongata ba lactate maling bo fetang 3 mmol / L bo bitsoa hyperlactatemia.
Liphetoho tsa 'mele nakong ea kemaro li ka lebisa tlolong ea metabolism ea carbohydrate, ha kholo ea placenta, khanyetso ea insulin e eketseha.
Boemo ba lactate bo ka eketseha ho lefu la tsoekere, ho nyekeloa ke pelo, mofets'e, likotsi, mafu, a tšoauoang ke litšibollo tse matla tsa mesifa, ka mesebetsi e amanang le ho fokola ha masapo le sebete. Joala le meriana e itseng le tsona li ka lebisa ho lactic acidosis.
Insulin Antibody Assay
Teko ea mali bakeng sa li-antibodies ho insulin - tlhahlobo ea li-antibodies tse ikamahanyang le li-antigen tsa 'mele oa hau, tlhahlobo ea tekanyo ea tšenyo ea autoimmune ho lisele tsa pancreatic beta, e sebelisoa tlhaisong ea lefu la lefu la tsoekere le itšetlehileng ka lefu la tsoekere. Tloaelo ea litaba tsa li-antibodies tsa autoimmune ho insulin ke 0-10 U / ml. Keketseho e ka bonts'a lefu la tsoekere la mofuta oa 1, lefu la Hirat, karabelo ea allergic ho insulin ea kantle, le polyendocrine autoimmune syndrome. Liphetho tse mpe ke tloaelo.
Tekanyetso ea boemo ba Fructosamine
Boikemisetso ba mahloriso a fructosamine (motsoako oa tsoekere le albin) - boikemisetso ba boemo ba tsoekere bakeng sa matsatsi a 14-20. Litekanyetso tsa litšupiso tse tloaelehileng tlhahlobisong ea li-fructosamine ke 205–285 μmol / L. Ka mellitus e lefuoang ea lefu la tsoekere, ho feto-fetoha ha maemo ho boleng ho ka ba maemong a 286-320 µmol / L; karolong e boletsoeng, fructosamine e nyolohela ho 370 µmol / L le ho feta. Keketseho ea letšoao e ka bonts'a ho hloleha ha ts'ebetso ea renal, hypothyroidism. Methati e phahamisitsoeng ea fructosamine e ka supa nts'etsopele ea lefu la tsoekere, ho se sebetse hantle ka mpeng, lefu la sebete, ho lemala le ho ruruha ha lesapo la mokokotlo, ho fokolisa tšebetso ea qoqotho. Ho fokotseha ho bontša ho lahleheloa ke protheine ke 'mele ka lebaka la nts'etsopele ea lefu la tsoekere, nephrotic syndrome, hyperthyroidism. Ho lekola sephetho sa sekaseka ho bona katleho ea kalafo, nahana ka mokhoa o lebisang phetohong ea letšoao.
Lefu la tsoekere la lefu la sethoathoa le fumanoa haeba tekanyo ea tsoekere ho sampole ea pele e feta 5.3 mmol / L, kamora hora e ne e phahame ho feta 10 mmol / L, kamora lihora tse 2 e ne e feta 8,6 mmol / L, kamora lihora tse 3 e feta 7.7 mmol / L.
Teko ea tsoekere ea mali kapele
Boithuto bo hlakileng ba ho khetholla khatello ea mali maling maling e sebelisoa ho laola glycemia ka mefuta ea lefu la tsoekere e itšetlehileng ka insulin. Bakeng sa ts'ebetso, ho sebelisoa li-glucometer tsa lapeng le metsero e ikhethang ea liteko, moo ho theoang lerotholi la mali ho tsoa monoana. Litsebi tsa lefu la tsoekere li hloka ho boloka tsoekere ka bongata ba 5.5-6 mmol / L.
Mokhoa oa ho lokisa le ho etsa tlhahlobo
Liteko tse ngata tsa laboratori tsa mali li khothaletsa ho isa thepa hoseng, kamora ho potlaka ho lihora tse 8-14. Bosiung ba thuto, ha ua lokela ho ja lijo tse mafura, tse halikiloeng, ho qoba khatello ea maikutlo le maikutlo. Pele ho ts'ebetso, ho lumelloa metsi a hloekileng feela. Hoa hlokahala ho kenyelletsa joala matsatsi a mabeli pele ho tlhahlobo, ka lihora tse 'maloa - emisa ho tsuba. Pele ho thuto, ka tsebo ea ngaka, khaotsa ho sebelisa meriana e amang sephetho.
Ho hlahlojoa ha hemoglobin ea glycated ho bonolo ho e nka, sephetho ha se ea itšetleha ka nako ea letsatsi leo mali a fanoang ka lona, ha ea lokela ho nkuoa ka mpeng e se nang letho.
Ha ho kgothaletswe ho etsa tlhahlobo ea tsoekere ea mali ka mor'a mekhoa ea phekolo, ts'ebetso, ka mafu a tšoaetsanoang haholo, ho ata ha pancreatitis e sa foleng, nakong ea ho ilela khoeli.
Hobaneng ha ho etsoa tlhahlobo ea tsoekere?
Boemo ba glycemia (glucose ea mali) e ka ba bo tloaelehileng, bo tlase kapa bo phahameng. Ka bongata bo eketsehileng ba tsoekere, hypoglycemia e fumanoa, 'me e tlase - hyperglycemia.
Hyperglycemia ke sesupo sa metabolism e sa foleng ea carbohydrate, e bontša nts'etsopele ea lefu la tsoekere kapa mafu a mang a tsamaiso ea endocrine. Tabeng ena, ho thehoa letšoao le rarahaneng la matšoao, le bitsoang hyperglycemic syndrome:
- hlooho e bohloko, bofokoli, mokhathala,
- polydipsia (lenyora le eketsehileng),
- polyuria (urination e eketsehileng)
- hypotension
- ho sitisoa ha pono
- ho theola boima ba 'mele
- tloaelo ea mafu a tšoaetsanoang,
- pholiso e liehang ea maqeba le likotsi,
- pelo lippitations,
- letlalo le omeletseng le le boreleli
- ho fokotseha ha kutloisiso ea leoto.
Hyperglycemia ea nako e telele e baka tšenyo hoo e batlang e le litho tsohle le lisele, le ho fokotseha hoa boits'ireletso.
Tekanyo ea hemoglobin ea glycated e tsoa ho 4 ho isa ho 6%. Tekanyo ea glycation ea hemoglobin e phahame haholo, ha tsoekere e ngata maling.
Hypoglycemia e kenyelletsa matla a ho bolaoa ke tlala ea lisele, tse sitisang ts'ebetso e tloaelehileng ea 'mele. Hypoglycemic syndrome e na le lipontšo tse latelang:
- hlooho e bohloko
- bofokoli
- tachycardia
- thothomela
- diplopia (pono e habeli),
- ho fufuleloa ho eketsehileng
- cramps
- ho tšoenyeha
- ho lahleheloa ke kelello.
Ka ho hlahloba matšoao a ka holimo, ngaka e fana ka tlhahlobo ea mali bakeng sa tsoekere. Ntle le moo, tlhahlobo ea tsoekere e bontšitsoe maemong a latelang:
- ho hlahloba le ho hlokomela lefu la tsoekere kapa lefu la tsoekere,
- ho nona haholo
- ho sitisoa ha pono
- vasher atherosulinosis,
- pathology ea pelo,
- mafu a tšoelesa ea tšoelesa ea qoqotho, tšoelesa ea adrenal, gland
- lefu la sebete
- botsofali
- lefu la tsoekere
- nalane e boima ea lelapa la lefu la tsoekere.
Hape, tlhahlobo ea tsoekere e etsoa e le karolo ea tlhahlobo ea bongaka.