Insulin: ketso ea li-hormone, tloaelo, mefuta, mesebetsi
Insulin ke proteni e hlophisitsoeng ke li-pancreatic β-cell 'me e na le liketane tse peli tsa peptide tse hokahaneng hammoho ka marokho a disulfide. E fana ka phokotseho ea khoholeho ea tsoekere e ngata serum, e nka karolo e tobileng ho metabolism ea carbohydrate.
Phello e ka sehloohong ea insulin ke ho ikopanya le li-membrane tsa cytoplasmic, ho lebisang keketseho ea matla a tsona a tsoekere.
Matšoao a tloaelo ea "insulin" maling a motho ea phetseng hantle a maemong a pakeng tsa 3 ho isa ho 30 μU / ml (kamora lilemo tse 60 - ho fihla ho 35 μU / ml, ho bana - ho fihla ho 20 μU / ml).
Maemo a latelang a lebisa phetohong ea ho kenella ha insulin maling.
- lefu la tsoekere
- mesifa dystrophy
- mafu a sa foleng
- acromegaly
- hypopituitarism,
- mokhathala oa tsamaiso ea methapo,
- tšenyo ea sebete
- Lijo tse sa nepahalang tse nang le lik'habohaedreite haholo lijong,
- botenya
- ho hloka boikoetliso
- ho ikoetlisa ka ho feteletseng
- neoplasms tse mpe.
Ts'ebetso ea insulin
Makhopho a makhopho a na le libaka tsa ho bokella lisele tsa β-cell tse bitsoang lihlekehleke tsa Langerhans. Lisele tsena li hlahisa insulin haufi le nako eohle. Kamora ho ja, khatello ea tsoekere ea mali ea phahama, ho arabela sena, ts'ebetso ea lekunutu ea lisele tsa β e ea eketseha.
Phello e ka sehloohong ea insulin ke ho ikopanya le li-membrane tsa cytoplasmic, ho lebisang keketseho ea matla a tsona a tsoekere. Ntle le lihormone tsena, tsoekere e ne e ke ke ea kenella liseleng, 'me ba ne ba tla bolaoa ke tlala.
Ntle le moo, 'meleng oa motho, insulin e etsa mesebetsi e meng e mengata ea bohlokoa ka tsela e tšoanang:
- tshusumetso ea motsoako oa mafura acid le glycogen ka har'a sebete,
- tshusumetso ea ho monya ha li-amino acid ka lisele tsa mesifa, ka lebaka leo ho nang le keketseho ea tlhahiso ea tsona ea glycogen le protheine,
- tsosa ea mofuta oa glycerol ho lipid tishu,
- khatello ea sebopeho sa 'mele oa ketone,
- khatello ea ho phatloha ha lipid,
- khatello ea ho phatloha ha glycogen le liprotheine lisele tsa mesifa.
Naheng ea Russia le ea CIS, bakuli ba bangata ba khetha ho fana ka insulin ba sebelisa lisirinji tse fanang ka dosing e nepahetseng ea lithethefatsi.
Kahoo, insulin ha e laole lik'habohaedreite feela, empa le mefuta e meng ea metabolism.
Mafu a Insulin
Ho ts'oaroa ha insulin ka bongata le ho lekana ha mmele ho baka nts'etsopele ea maemo a methapo:
- insulinoma - hlahala ea "pancreatic tumor" e bolokang insulin ka bongata bo boholo, ka lebaka leo mokuli a atisang ho ba le maemo a hypoglycemic (a supang ho fokotseha ha khatello ea "glucose" serum ea mali ka tlase ho 5.5 mmol / l),
- Type I lefu la tsoekere mellitus (mofuta o itšetlehileng ka insulin) - nts'etsopele ea eona e hlahisoa ke tlhahiso e sa lekaneng ea insulin ke "li-pancreatic β-cell (khaello e phethahetseng ea insulin),
- mofuta II lefu la tsoekere mellitus (mofuta o sa itšetleheng ka insulin) - lisele tsa "pancreatic" li hlahisa "insulin" e lekaneng
- ho ts'oaroa ha insulin - boemo ba lefu le hlahang ka lebaka la ente e le 'ngoe ea insulin e feteletseng (maemong a tebileng, hypoglycemic coma),
- Somoji syndrome (e sa foleng ea insulin overdose syndrome) - ramatiki ea matšoao a hlahang ho bakuli ba fumanang litekanyetso tse phahameng tsa insulin nako e telele.
Phekolo ea insulin
Phekolo ea insulin ke mokhoa oa kalafo o reretsoeng ho felisa mathata a metabolic a lik'habohaedreite mme a thehiloe ka ente ea insulin. E sebelisoa haholo kalafong ea mofuta oa lefu la tsoekere la mofuta oa lefu la tsoekere, le maemong a mang ka lefu la tsoekere la mofuta oa II. Ke ka seoelo, kalafo ea insulin e sebelisoang ho sebeliseng mafu a kelello, e le e 'ngoe ea mekhoa ea ho phekola lefu la kelello (kalafo ka hypoglycemic coma).
E le ho qapolla secretion ea basal, mefuta e meng ea insulin e fanoa hoseng le mantsiboea. Kamora lijo tse ling le tse ling tse nang le lik'habohaedreite, ho fanoa ka insulin e khutšoane.
Matšoao a kalafo ea insulin ke:
- mofuta oa lefu la tsoekere
- lefu la tsoekere, hyperlacticemic coma, ketoacidosis,
- ho sitoa ho fumana matšeliso bakeng sa metabolism ea carbohydrate ho bakuli ba nang le mofuta oa II lefu la tsoekere le lithethefatsi tse fokotsang tsoekere, ho ja le ho ikoetlisa ka mosebetsi.
- lefu la tsoekere
- lefu la tsoekere.
Liente li fanoa butle-butle. Li etsoa ka ho sebelisa syringe e khethehileng ea insulin, pente ea syringe kapa pompo ea insulin. Naheng ea Russia le ea CIS, bakuli ba bangata ba khetha ho fana ka insulin ba sebelisa lisirinji, tse fanang ka litekanyetso tse nepahetseng tsa lithethefatsi le tsamaiso ea eona e batlang e se bohloko.
Ha ho sehlopha sa bakuli ba nang le lefu la tsoekere ba fetang 5% ba sebelisang lipompo tsa insulin. Sena se bakoa ke theko e phahameng ea pompo le ho rarahana ha tšebeliso ea eona. Leha ho le joalo, tsamaiso ea insulin ka pompo e fana ka mohlala o nepahetseng oa ho secretion ea eona ea tlhaho, e fana ka taolo e ntlafalitsoeng ea glycemic, hape e fokotsa kotsi ea litlamorao tsa lefu la tsoekere le tsa nako e telele. Ka hona, palo ea bakuli ba sebelisang lipompo tsa metering ho phekola lefu la tsoekere e ntse e eketseha ka sekhahla.
Tloaelong ea bongaka, ho sebelisoa mefuta e fapaneng ea kalafo ea insulin.
Phekolo ea insulin e kopaneng (ea setso)
Mokhoa ona oa phekolo ea lefu la tsoekere o ipapisitse le tsamaiso e le 'ngoe ea motsoako oa li-insulin tse nkang nako e telele le tse telele, tse fokotsang palo ea liente tsa letsatsi le letsatsi.
Melemo ea mokhoa ona:
- ha ho na tlhoko ea ho lekola khafetsa khatello ea tsoekere ea mali,
- kalafo e ka etsoa tlasa taolo ea tsoekere maling ka moriring (boemo ba glucosuric).
Kamora ho ja, khatello ea tsoekere ea mali ea phahama, ho arabela sena, ts'ebetso ea lekunutu ea lisele tsa β e ea eketseha.
- tlhoko ea ho latela litloaelo tsa letsatsi le letsatsi, ho ikoetlisa,
- tlhokeho ea ho latela kalafo ka botlalo lijong tse boletsoeng ke ngaka, ho nahana ka tekanyetso e fanoeng,
- tlhoko ea ho ja bonyane makhetlo a 5 ka letsatsi mme o lula a le ka nako e le 'ngoe.
Phekolo ea setso ea "insulin" e lula e tsamaea le hyperinsulinemia, ka mantsoe a mang, ho na le "insulin" e ngata maling. Sena se eketsa menyetla ea ho ba le mathata a kang atherosclerosis, khatello ea mali ea methapo, hypokalemia.
Ha e le hantle, kalafo ea "insulin" ea setso e fuoe mefuta e latelang ea bakuli:
- maqheku
- ho tšoaroa ke bokuli ba kelello
- boemo bo tlase ba thuto
- e hlokang tlhokomelo ya kantle
- ho se khone ho latela mokhoa o khothalletsoang oa letsatsi le letsatsi oa ho ja, oa ho ja, nako ea tsamaiso ea insulin.
Therapy e matlafalitsoeng ea Insulin
Phekolo ea insulin e matlafalitsoeng e etsisa tsoelopele ea 'mele ea mokuli' meleng.
E le ho qapolla secretion ea basal, mefuta e meng ea insulin e fanoa hoseng le mantsiboea. Kamora lijo tse ling le tse ling tse nang le lik'habohaedreite, ho fanoa ka insulin e nkang nakoana (ho etsisa setla-morao sa ho ja). Tekanyetso e lula e fetoha ho latela lijo tse jang.
Melemo ea mokhoa ona oa kalafo ea insulin ke:
- ho etsisa moralo oa mmele oa secretion,
- bophelo bo botle ho bakuli
- bokhoni ba ho latela tloaelo le lijo tse hlabollang letsatsi le letsatsi,
- ho fokotsa kotsi ea ho ba le mathata a morao-rao a lefu la tsoekere.
Likotsi li kenyeletsa:
- tlhokeho ea bakuli ho ithuta ho bala XE (likotoana tsa bohobe) le mokhoa oa ho khetha tekanyetso e nepahetseng,
- tlhokeho ea ho etsa tlhahlobo ea boitšoaro bonyane makhetlo a 5-7 ka letsatsi,
- tloaelo e eketsehileng ea ho nts'etsapele maemo a hypoglycemic (haholoholo likhoeling tsa pele tsa kalafo).
Mefuta ea insulin
- mofuta o le mong (monovid) - Ho hlahisa makhopho a makhopho a mefuta e le 'ngoe ea liphoofolo,
- kopaneng - e na le motsoako oa li-pancreatic tse tsoang liphoofolong tse peli kapa ho feta tsa liphoofolo.
Matšoao a tloaelo ea "insulin" maling a motho ea phetseng hantle a maemong a pakeng tsa 3 ho isa ho 30 μU / ml (kamora lilemo tse 60 - ho fihla ho 35 μU / ml, ho bana - ho fihla ho 20 μU / ml).
Ka mefuta:
- motho
- nama ea kolobe
- likhomo
- whale.
Ho latela tekanyo ea tlhoekiso, insulin ke:
- setso - e na le litšila le li-hormone tse ling tsa pancreatic,
- monopic - ka lebaka la filtara e eketsehileng ho lijusi, litaba tsa litšila tse ho eona li tlase haholo ho feta moetlong,
- monocomponent - e tšoauoa ka bohloeki bo phahameng (ha e na litšila tse fetang 1%).
Ka nako le ketsahalo e phahameng, li-insulin tsa nako e khuts'oane le tse telele (tse mahareng, tse telele le tse telele-tse telele) li bolokiloe.
Litokisetso tsa insulin ea khoebo
Bakeng sa kalafo ea bakuli ba nang le lefu la tsoekere, ho sebelisoa mefuta e latelang ea insulin:
- Insulin e bonolo. E emeloa ke litokisetso tse latelang: Actrapid MC (nama ea kolobe, monocomponent), Actrapid MP (nama ea kolobe, monopik), Actrapid HM (moenjiniere oa liphatsa tsa lefutso), Insuman Rapid HM le Humulin Regular (genjini ka enjene). E qala ho sebetsa metsotso e 15-20 ka mor'a tsamaiso. Phello e phahameng e bonoa kamora lihora tse 1.5-3 ho tloha nakong ea ente, bolelele ba ts'ebetso ke lihora tse 6-8.
- NPH kapa ho nka insulin nako e telele. Pele ho USSR, ba ne ba bitsoa protamine-zinc-insulins (PCI). Pele, ba ne ba laetsoe hanngoe ka letsatsi ho etsa secretion ea basal, mme li-insulin tse nkang nakoana li ne li sebelisetsoa ho lefella ho nyoloha ha tsoekere ea mali ka mor'a lijo tsa hoseng le tsa mantsiboea. Leha ho le joalo, katleho ea mokhoa ona oa ho khalemela mafu a amanang le metabolism ea carbohydrate e ne e sa lekana, 'me hajoale bahlahisi ba ntse ba lokisa motsoako o entsoeng ka mokhoa o lokiselitsoeng ba sebelisa NPH-insulin, e ka fokotsang palo ea liente tsa insulin habeli ka letsatsi. Kamora ho tsamaisoa ha subcutaneous, ts'ebetso ea NPH-insulin e qala ka lihora tse 2-5, e fihlella ka lihora tse 6-10 mme e nka lihora tse 16-18. Mofuta ona oa insulin o hlahisoa 'marakeng ke lithethefatsi tse latelang: Insuman Basal, Humulin NPH, Protaphane HM, Protaphane MC, MP ea Protaphane.
- Li-motsoako tse lokiselitsoeng tse lokiselitsoeng (li tsitsitseng) tsa NPH le insulin e nkang nakoana. Tsamaiso e tsamaisoa ka mokhoa o sa sebetseng habeli ka letsatsi. Ha e ea lokela bakuli bohle ba nang le lefu la tsoekere. Naheng ea Rashea, ho na le motsoako o le mong o tsitsitseng o entsoeng ke Humulin M3, o nang le "insulin" e khutšoane ea "insulin" ea kamehla le 70% Humulin NPH. Karolelano ena ha e khopise ho hlaha hoa hyper- kapa hypoglycemia.
- Li-insulin tse phahameng ka nako e telele. Li sebelisoa feela bakeng sa kalafo ea bakuli ba nang le mofuta oa lefu la tsoekere la mofuta oa II ba hlokang khatello e matla ea insulin ka serum ea mali ka lebaka la ho hanyetsa (ho hanyetsa) ha lisele tsa lona. Tsena li kenyelletsa: Ultratard HM, Humulin U, Ultralente. Ketso ea "insulin" e matla e qala ka mor'a lihora tse 6-8 ho tloha nakong ea tsamaiso ea bona e tsamaeang butle. Bophahamo ba eona bo fihlelloa kamora lihora tse 16 ho isa ho tse 20, 'me nako ea ts'ebetso ke lihora tse 24,36.
- Human Insulin Analogs ea nakoana e khutšoane (Humalog)e fumanoang ke boenjiniere ba liphatsa tsa lefutso. Ba qala ho sebetsa nakong ea metsotso e 10-20 kamora ho tsamaisoa ha subcutaneous. Tlhōrō e fihlelloa kamora metsotso e 30-90, nako eohle ea tšebetso ke lihora tse 3-5.
- Li-analoggs tsa insulin ea motho ea sa tsitsang (e telele) ketso. Phello ea bona ea ho phekola e thehiloe ho thibeng semelo sa lisele tsa "pancreatic alpha" tsa glucagon ea hormone, mohanyetsi oa insulin. Nako ea ts'ebetso ke lihora tse 24, ha ho na tlhoriso e phahameng. Baemeli ba sehlopha sena sa lithethefatsi - Lantus, Levemir.
Ketso ea insulin
Ka tsela e itseng, insulin e ama mefuta eohle ea metabolism 'meleng, empa, pele ho tsohle, e nka karolo ho metabolism ea carbohydrate. Phello ea eona e bakoa ke keketseho ea tekanyo ea ho fetisoa ha tsoekere e feteletseng ka li-membrane tsa sele (ka lebaka la ts'ebetso ea ts'ebetso ea methapo e laolang tekanyo le katleho ea liprotheine tsa membrane tse tsamaisang tsoekere). Ka lebaka leo, li-insulin receptors lia hlohlelletsoa, 'me ho kenngoa tšebetso ea methapo e matla e amang tšusumetso ea "glucose" ke lisele.
Adipose le mesifa ea mesifa ha ea itšetleha ka insulin. Ha lijo tse nang le lik'habohaedreite tse ngata li kena, lihormone li hlahisoa 'me li baka tsoekere ea mali. Ha glucose ea mali e theoha ka tlase ho boemo ba 'mele, tlhahiso ea li-hormone e ea fokotseha.
Mefuta ea ketso ea insulin 'meleng:
- metabolic: ho kenyelletsa glucose le lintho tse ling ka lisele, ts'ebetso ea li-enzyme tsa bohlokoa tsa tšebetso ea glucose oxidation (glycolysis), ho eketseha ha glycogen synthesis (ho potlakisa boemo ba glycogen ka ho ts'oaroa ha glucose ka har'a lisele tsa mesifa le mesifa), ho fokotsa matla a gluconeogeneis ka tlhahiso ea glucose e tsoang linthong tse fapaneng tsoekere.
- anabolic: e ntlafatsa ho kenngoa ha li-amino acid ka lisele (hangata li-valine le leucine), e eketsa ho tsamaisoa ha potasiamo, magnesium le phosphate ions ka liseleng, e eketsa phetisetso ea deoxyribonucleic acid (DNA) le protheine ea biosynthesis, e potlakisa ho hlophisoa ha acid e ngata e lateloang ke ho lekana ha bona (ka har'a sebete le adipose tishu insulin e khothalletsa phetoho ea tsoekere ho triglycerides, mme ka ho haella ha eona, ho hlohlelletsa mafura hoa hlaha),
- anti-catabolic: thibelo ea li-hydrolysis tsa protheine ka ho fokotseha ha tekanyo ea ho senyeha ha tsona, ho fokotseha ha lipolysis, tse fokotsang tšebeliso ea mafura a mangata maling.
Ente ea insulin
Tloaelo ea insulin maling a motho e moholo ke 3-30 mcU / ml (ho fihla ho 240 pmol / l). Bakeng sa bana ba ka tlase ho lilemo tse 12, letšoao lena ha lea lokela ho feta 10 mcED / ml (69 pmol / l).
Bathong ba phetseng hantle, boemo ba li-hormone boa fokotseha letsatsi lohle mme bo fihla sehlohlolong sa bona ka mor'a ho ja. Morero oa phekolo ea "insulin" ha se feela ho boloka boemo bona letsatsi lohle, empa hape le ho etsisa litlhoro tsa eona, tseo lihormone li tsamaisoang hanghang pele ho lijo. Tekanyetso e khethoa ke ngaka ka bonngoe ho mokuli e mong le e mong, ho nahanela boemo ba tsoekere maling.
Secretion ea basal secretion ho motho ea phetseng hantle e batla e le 1 IU ka hora, hoa hlokahala ho hatella mosebetsi oa lisele tsa alpha tse hlahisang glucagon, e leng mohanyetsi oa mantlha oa insulin. Ha ho ja, secretion e nyolohela ho PIERESI ea 1-2 ka 10 g ea lik'habohaedreite tse nkuoeng (palo e nepahetseng e ipapisitse le lintlha tse ngata, ho kenyelletsa boemo ba mmele ka kakaretso le nako ea letsatsi). Lerotholi lena le u lumella ho theha botsitso bo matla ka lebaka la tlhahiso e eketsehileng ea insulin ho arabela tlhokahalo e eketsehileng ea eona.
Ho batho ba nang le lefu la tsoekere la mofuta oa 1, tlhahiso ea li-hormone e ea fokotsoa kapa e sieo ka ho felletseng. Maemong ana, ho hlokahala hore ho phekoloe insulin kalafo.
Ka lebaka la tsamaiso ea molomo, li-hormone li senyeha ka mpeng, ka hona e tsamaisoa ka mokhoa oa botsoali, ka liente tsa subcutaneous. Ho feta moo, le ho fokotseha ho fokola ha letsatsi le letsatsi maemong a tsoekere, ho fokotsang kotsi ea ho ba le mathata a mangata a lefu la tsoekere.
Kamora ho fumana insulin e sa lekaneng, hyperglycemia e ka hlaha, haeba hormone e feta, ho ka etsahala hypoglycemia. Mabapi le sena, liente tsa moriana li lokela ho tšoaroa ka mokhoa o nang le boikarabelo.
Liphoso tse fokotsang katleho ea kalafo, tse lokelang ho qojoa:
- tšebeliso e mpe ea lithethefatsi,
- tlolo ea melao ea polokelo le ea ho tsamaisa sethethefatsi,
- ho sebelisa joala setsing sa ente ea joala (joala bo na le tšusumetso e matla holiming)
- ts'ebeliso ea nale e senyehileng kapa syringe,
- ho tlosa syringe kapele haholo ka mor'a ente (ka lebaka la kotsi ea ho lahleheloa ke karolo ea moriana).
Kalafo ea Insulin e tloaelehileng le e matlafalitsoeng
Phekolo e tloaelehileng kapa e kopaneng ea insulin e khetholloa ka ho hlahisoa ha motsoako oa lithethefatsi ka nako e khuts'oane le e bohareng / e telele ea ts'ebetso ka ente e le 'ngoe. E sebetsa le thutong ea lefu la tsoekere. Monyetla o ka sehloohong ke bokhoni ba ho fokotsa palo ea liente ho isa ho 1-3 ka letsatsi, leha ho le joalo, ho ke ke ha khoneha ho fumana matšeliso a felletseng a metabolism ea carbohydrate ka mokhoa ona oa kalafo.
Phekolo ea lefu la tsoekere la setso:
- Melemo: boiketlo ba ho sebelisa lithethefatsi, ho haella ha tlhoko ea taolo ea glycemic khafetsa, monyetla oa kalafo tlasa taolo ea boemo ba glucosuric,
- likotsi: tlhoko ea ho latela kalafo ka tieo ho ja, tloaelo ea letsatsi le letsatsi, ho robala, ho phomola le ho ikoetlisa, ho ja lijo tse tlamang le tse tloaelehileng, tse tlameletsoeng ho hlahisa moriana, ho se khone ho boloka maemo a tsoekere maemong a phallo ea mmele, kotsi e eketsehang ea hypokalemia, khatello ea methapo ea methapo ea methapo le methapo ka lebaka la hyperinsulinemia, tšobotsi ea mokhoa ona oa kalafo.
Pheko ea ho kopanya e bontšoa ho bakuli ba tsofetseng haeba ho ka ba le mathata ka ho fumana litlhoko tsa kalafo e matlafalitsoeng, ka mathata a kelello, boemo bo tlase ba thuto, tlhoko ea tlhokomelo ea kantle, le bakuli ba sa rutehang.
Ho etsa ts'ebetso ea insulin e matlafalitsoeng (IIT), mokuli o fuoa lethal dose le lekaneng la ho sebelisa tsoekere e kenang 'meleng, ka lebaka lena ho ts'oaroa li-insulin ho qhekella secretion ea basal, le lithethefatsi tse ikhethileng tse khutšoane tse fanang ka lintlha tsa sehloho tsa lihormone kamora ho ja. Tekanyetso ea letsatsi le letsatsi ea lithethefatsi e na le li-insulin tse khutšoane le tse telele.
Ho batho ba nang le lefu la tsoekere la mofuta oa 1, tlhahiso ea li-hormone e ea fokotsoa kapa e sieo ka ho felletseng. Maemong ana, ho hlokahala hore ho phekoloe insulin kalafo.
Kalafo ea lefu la tsoekere:
- Melemo: ho etsisa mokhoa o mong oa ho boloka mmele o sirelletsa 'mele (basal e hlohlellehileng), mokhoa oa bophelo o lokolohileng le tloaelo ea letsatsi le letsatsi bakeng sa bakuli ba sebelisang "lijo tse lokolohileng" ka linako tse fapaneng tsa lijo le sete ea lijo, bophelo bo ntlafalitsoeng ba bophelo, taolo e sebetsang ea mathata a metabolic, ho netefatsa thibelo ea mathata a morao-rao ,
- Litsietsi: tlhoko ea ho itlhahloba ka mokhoa o hlophisitsoeng oa glycemia (ho fihlela makhetlo a 7 ka letsatsi), tlhoko ea koetliso e khethehileng, liphetoho tsa mokhoa oa bophelo, litefiso tse eketsehileng tsa ho ithuta le lisebelisoa tsa ho itlhokomela, keketseho ea tloaelo ea hypoglycemia (haholo-holo qalong ea IIT).
Maemo a tlamang a ts'ebeliso ea IIT: tekanyo e lekaneng ea bohlale ba mokuli, bokhoni ba ho ithuta, bokhoni ba ho sebelisa tsebo eo u ithutileng eona, bokhoni ba ho fumana mekhoa ea boitšoaro.
Hypoglycemic hormone le ts'ebetso ea eona ea ts'ebetso?
Insulin 'meleng oa motho e ikarabella bakeng sa ho laola maemo a tsoekere ea mali. Ts'ebetsong ena, o boetse o thusoa ke lintho tse ling tse sebetsang, tse kang adrenaline le norepinephrine, glucagon, cortisol, corticosterol le lihomone tsa qoqotho.
Tekanyo ea tsoekere e ngata 'meleng e eketseha hang ha motho a ja lihlahisoa tsa lik'habohaedreite. Ho arabela khaello ea lijo tse joalo, manyeme a qala ho hlahisa palo e hlokahalang ea "insulin", e qalang ts'ebetso ea ts'ebeliso ea tsoekere, a e fetisetse ka mali ho fihlela 'mele.
Re lokela ho hlokomela hore hang ha boemo ba glucose maling bo tloaelehile, tlhahiso ea insulin, ka ts'ebetso e tloaelehileng ea manyeme, ea emisa. Haeba ho e-na le ho se sebetse hantle mosebetsing o joalo o thehiloeng, 'mele, mme kamora ho etsa tsoekere e tloaelehileng, ha e emise ho hlahisa hormone ena.
E ea batla
Insulin 'meleng oa motho e ikarabella bakeng sa ho laola maemo a tsoekere ea mali. Ts'ebetsong ena, o boetse o thusoa ke lintho tse ling tse sebetsang, tse kang adrenaline le norepinephrine, glucagon, cortisol, corticosterol le lihomone tsa qoqotho.
Mefuta ea lihormone
Matla a insulin 'meleng a sebelisoa kalafong. Phekolo ea lefu la tsoekere e laetsoe ke ngaka kamora thuto. Mofuta oa lefu la tsoekere o otlang mokuli ke eng, litšobotsi tsa hae ke eng, ho ferekana le ho se mamelle lithethefatsi. Hobaneng ha re hloka insulin bakeng sa lefu la tsoekere, ho hlakile - ho theola boemo ba tsoekere.
Mefuta ea hormone ea "insulin" e etselitsoeng lefu la tsoekere:
- Ho sebetsa ka potlako insulin. Ketso ea eona e qala metsotso e 5 kamora ho ente, empa kapele e fela.
- Nakoana. Hormone ee ke eng? O qala ho nka khato hamorao - kamora halofo ea hora. Empa ea thusa haleletsana.
- Nako e mahareng. E khetholloa ke phello ho mokuli bakeng sa nako e ka bang halofo ea letsatsi. Hangata e fanoa hammoho le e potlakileng, e le hore mokuli a ka ikutloa a imoloha hanghang.
- Ketso e telele. Hormone ena e sebetsa har'a motšehare. E tsamaisoa hoseng ka mpa e se nang letho. E boetse e sebelisoa hangata hammoho le lihormone tsa ts'ebetso e potlakileng.
- E tsoakiloe. E fumanoa ka ho kopanya li-hormone tse potlakileng le ketso e mahareng. E etselitsoe batho ba fumanang ho le thata ho kopanya lihormone tse peli tsa liketso tse fapaneng tekong e nepahetseng.
Re hlokometse hore na insulin e sebetsa joang. Motho e mong le e mong o arabela ka mokhoa o fapaneng ka ente ea hae. Ho latela ts'ebetso ea phepo e nepahetseng, thuto ea 'mele, lilemo, bong le mafu a kopaneng. Ka hona, mokuli ea nang le lefu la tsoekere o lokela ho ba tlasa tlhokomelo ea bongaka e tsoelang pele.
Synthetic insulin - ke eng?
Mahlale a morao-rao a meriana a etsa hore ho be bonolo ho fumana li-hormone tse joalo ka maiketsetso ebe ka mor'a moo o li sebelisa ho phekola mefuta e fapaneng ea lefu la tsoekere.
Kajeno, ho na le mefuta e fapaneng ea insulin e hlahisoang e lumellang batho ba nang le lefu la tsoekere ho e sebelisa maemong a fapaneng.
Mefuta e fapaneng ea lihomone tsa tlhaho tsa maiketsetso tse sebelisetsoang ente ea subcutaneous li kenyeletsa:
- Ntho ea ho pepesetsoa ha ultrashort ke lithethefatsi tse bonts'ang mesebetsi ea eona nakong ea metsotso e mehlano ka mor'a tsamaiso. Phello e phahameng ea kalafo e bonoa hoo e ka bang hora e le ngoe ka mor'a ente. Ka nako e ts'oanang, phello ea ente e nka nakoana.
- Insulin e sebetsang ka nako e khuts'oane e qala ho sebetsa hoo e ka bang halofo ea hora kamora ho tsamaisoa ha eona ka tlasa letlalo. Re lokela ho hopola hore insulin e joalo e lokela ho nkuoa ka metsotso e leshome le metso e mehlano pele ho lijo. Maemong ana, ho tla khonahala ho fihlella phello e phahameng ea kalafo. Ha e le molao, lihormone tsohle tse nkang nako e khuts'oane li etselitsoe ho fokotsa ponahalo ea hyperglycemia, eo hangata e bonoang ka mor'a lijo ho batho ba nang le lefu la tsoekere.
- Hormone ea nako e mahareng e sebelisoa hangata hammoho le li-insulin tse khutšoane. Nako ea bona, e le molao, e nka lihora tse leshome le metso e 'meli ho isa ho tse leshome le metso e tšeletseng. Bakeng sa mokuli ea nang le lefu la tsoekere, ho tla lekana ho etsa liente tse peli ho isa ho tse tharo tsa moriana o joalo ka letsatsi. Phello ea kalafo ka mor'a hore ente e qale ho hlaha kamora lihora tse peli ho isa ho tse tharo, 'me khatello e phahameng maling e bonoa kamora lihora tse ka bang tse tšeletseng ho isa ho tse robeli.
- Insulin e sebetsang ka nako e telele e sebelisoa hammoho le li-insulin tse khutšoanyane. E tlameha ho fanoa hang ka letsatsi, hangata hoseng. Morero o ka sehloohong oa ts'ebetso ea insulin ke ho boloka boemo bo tloaelehileng ba glycemia bosiu. Ho sebetsa ha ente e kenngoeng hantle ho qala ho hlaha kamora lihora tse ka bang tse tšeletseng, 'me phello ka boeona e ka nka lihora tse mashome a mabeli a metso e mene ho isa ho tse mashome a mararo a metso e tšeletseng.
Ho boetse ho na le sehlopha se khethehileng sa meriana, e leng motsoako oa mefuta e 'meli ea lihormone - tse khutšoane le tse telele (li tlameha ho tsoakoa hang-hang pele li fana ka moriana). E le molao, motsoako o joalo oa insulin o nooa hang-hang pele o ja habeli ka letsatsi.
Ho ke ho hlokomeloe hore lithethefatsi tsohle tsa maiketsetso tsa insulin li ntšoa ka motheo oa lihormone tsa motho.
Molao-motheo oa ts'ebetso ea insulin o hlalositsoe videong ena.
Synthetic insulin - ke eng?
Matšoao a tloaelehileng le tlhahlobo ea mafu
Insulin ke hormone e nang le phello ea hypoglycemic.
Ho haella ha eona kapa ho fetella ho tla iponahatsa ka sebopeho sa matšoao a fapaneng.
Teko ea ho fumana hore na lihormone tse kae 'meleng e ka khethoa ke ngaka kapa ke sephetho sa takatso e tsebahalang ea mokuli bakeng sa thibelo.
Matšoao a tloaelehileng a hore na lihormone li thehiloe hakae ke li-postulate tsa bongaka meeling e latelang:
- bongoaneng, maemo a insulin a ka ba tlase hanyane ho feta ho batho ba baholo, mme a qala ho tloha ho tse tharo ho isa ho tse mashome a mabeli ka unit
- ho banna le basali, meeli e tloaelehileng e bolokiloe ho fihlela letšoao le holimo la likarolo tse mashome a mabeli a metso e mehlano
- nalane ea lihormone ea basali ba baimana e ba le liphetoho tse kholo, ka hona, nakong ena, ho tloha ho likarolo tse tšeletseng ho isa ho tse mashome a mabeli a metso e robeli ka mohato ho nkoa e le tloaelo ea insulin.
Lefu la tsoekere, le etsoang ho fumana li-insulin tsa hormone (tsohle tseo u hlokang ho li tseba) le palo ea tsona 'meleng, li kenyelletsa pokello ea mali a venous.
Maemong ana, lits'ebetso tsa boitokisetso e tla ba melao e tloaelehileng:
- Mohlala oa lisebelisoa tsa tlhahlobo o etsoa hoseng 'me o lula o le ka mpeng. Sena se bolela hore motho ha a lokela ho ja lijo le lino tse fapaneng (ntle le metsi a tloaelehileng) bonyane lihora tse robeli ho isa ho tse leshome pele ho ts'ebetso.
- Ntle le moo, tse sa lumelloang li kenyelletsa ho hlatsoa meno ka litlolo tse nang le tsoekere, ho sefa molomo ka lihlahisoa tse khethehileng tsa bohloeki le ho tsuba.
- Re lokela ho hlokomela hore ho nka lihlopha tse itseng tsa lithethefatsi ho ka khopamisa setšoantšo sa 'nete. Ka hona, ho hlokahala hore ho behelle kantle ho bona ho kena 'meleng matsatsing a pele a sampole ea mali (ntle le haeba lithethefatsi tse joalo li bohlokoa bakeng sa motho), ngaka e eang teng e etsa qeto ea ho etsa maemong a hajoale.
- Bosiung ba ts'ebetso ea ho hlahloba, ha ho kgothaletswe ho bapala lipapali kapa ho jarisa 'mele haholo ka ho ikoetlisa ka matla.
Ntle le moo, haeba ho khonahala, u se ke ua sithabetsoa ke khatello ea maikutlo le maikutlo a mang a feteletseng.
Hang-hang pele ho ts'ebetso, o hloka ho theola moea le ho phomola hanyane (metsotso e leshome ho isa ho e leshome le metso e mehlano).
Insulin ke hormone e nang le phello ea hypoglycemic.
Liphello tsa mathata a tlhahiso ea insulin
Ha ho sebetsoa hantle ha setho sefe kapa sefe, boemo ba mmele ka kakaretso bo tla ba le tšusumetso e mpe. Ha e le ts'ebetso e mpe ea ts'ebetsong ea manyeme, e ka lebisa ho li-pathologies tse ngata tse tebileng le tse kotsi, tse ka bang thata ho sebetsana le tsona esita le ho sebelisa mekhoa ea kajeno ea kalafo.
Haeba u hlokomoloha litlhahiso tsa ngaka tsa ho felisa lefu lena, lefu lena le fetoha le sa foleng. Ka hona, ho hlakile hore motho ha a lokela ho lieha ho amoheloa ha mehato - ho molemo ho etela setsebi hape se ka thusang ho khethoa ha kalafo e nepahetseng, ka ho latela mathata ana.