Ọbara glucose: ọdịnaya nkịtị na nyocha

N ’ọnụ mmadụ, mgbaze glycogen na stachi na-amalite n’okpuru nke amylase nke nnu. N'okpuru mmetụta amylase na obere eriri afọ, njedebe ikpeazụ nke polysaccharides ka maltose pụtara.

Ihe dị n’ime ihe ọ juiceụinalụ eriri afọ nke ọtụtụ hydrolases - enzymes na-akụda sucrose, maltose na lactose (disaccharides) ka ọ bụrụ fructose, galactose na glucose (monosaccharides).

Galactose na glucose na - enweta ngwa ngwa site na microvilli nke obere eriri afọ, ha na - abanye n'ọbara ma rute imeju.

A na-achọpụta usoro glucose na ihe ndọpụ iche na plasma, yana n'ọbara ọbara, a na-ekesa ya n'etiti ihe mebere na plasma.

Ihe na-egosi glucose bụ isi ihe na-egosi metabolism, yana ngwaahịa ndị nwere carbohydrate bụ:

1. polysaccharides: stachi na cellulose,
2. fructose na glucose,
3. agara na lactose,
4. ụdị shuga ndị ọzọ.

Ugwu glucose dị larịị:

• maka umu aka, akaghi aka bu 1.1-3.33 mmol / l,
• maka ụmụ amụrụ ọhụrụ 1 ụbọchị 2.22-3.33 mmol / l,
• maka ụmụaka kwa ọnwa 2.7-4.44 mmol / l,
• maka ụmụaka karịrị afọ ise, 3.33-5.55 mmol / l,
• n’oge okenye rue 60 4.44-6.38 mmol / l,
• ndị mmadụ nọ n’agbata afọ 60 - ụkpụrụ bụ 4.61-6.1 mmol / l.

A na-enye ndị okenye hypoglycemia ma ọ bụrụ na ọdịnaya glucose erughi 3.3 mmol / L. A na-etinye shuga dị elu (ma ọ bụ n'ọnọdụ ụfọdụ ọbụna hyperglycemia) ma ọ bụrụ na nyocha ahụ kpughere na ọdịnaya glucose dị elu karịa 6.1 mmol / l.

Ọ dị mkpa ịmara na imebi metabolism metabolism na-amalite na ọkwa ọ bụla nke metabolism metabolism. Nke a nwere ike ịbụ mgbe a na-agbari shuga na ngụkọ diges, na-etinye n'ime obere eriri afọ ma ọ bụ na ọkwa nke cellular carbohydrates n'ahụ mmadụ.

Enwere ike ịme hyperglycemia ma ọ bụ mmụba nke ịba glucose site na:

1. physiological hyperglycemia: ị smokingụ sịga na-ebu ọnụ, nchekasị, mmega ahụ ezughi oke, mmetụta na-adịghị mma, nnukwu adrenaline na-agbacha ọsọ mgbe etinyere ya,
2. ọrịa shuga na ndị nọ n'afọ ndụ niile,
3. ọbara ọgbụgba n'ụbụrụ,
4. gigantism, acromegaly, thyrotoxicosis, pheochromocytoma na ọrịa endocrine ndị ọzọ,
5. Ọrịa pancreatic, dịka ọmụmaatụ, na-adịghị ala ala ma ọ bụ nnukwu pancreatitis, cystic fibrosis, hemochromatosis na etuto ahụ,
6. ọrịa nke sistem, diges na akụrụ,
7. ọnụnọ nke ọgwụ mgbochi ọrịa nye ndị na - anabata insulin
8. ihe eji caffeine, thiazides, glucocorticoids na estrogens.

Hypoglycemia ma ọ bụ mbelata glucose nwere ike ịbụ na:

• Ọrịa pancreatic: adenoma, carcinoma, hyperplasia, insulinoma, glucagon erughi,
• hypothyroidism, ọrịa adrenogenital, ọrịa Addison, hypopituitarism,
• n’ime nwata n’afọ n’afọ nke nwanyị nwere ọrịa shuga mụrụ
• ngafe nke insulin na hypoglycemic elekọta mmadụ,
• ọrịa imeju siri ike: carcinoma, cirrhosis, hemochromatosis, ịba ọcha n'anya,
• etuto ahụ na-adịghị ala ala: fibrosarcoma, kansa nke afọ ma ọ bụ adrenal gland,
• galactosemia, ọrịa gyrke,
• ụdị nsogbu dịgasị iche iche nke enweghị onwe, afọ, gastroenterostomy, post-gastroectomy, eriri afọ motility aghara,
• ibu ọnụ, ọrịa malabsorption na nsogbu iri nri ndị ọzọ,
• nsị na salicylates, arsenic, chloroform, antihistamines ma ọ bụ mmanya na-egbu,
• mgbasi ike nkịtị na ahụ ọkụ,
• iji amphetamine, steroid na propranolol.

Na ọgwụ, enwere otu ọnọdụ etiti, ọ bụghị ezigbo ọrịa shuga, mana ọbụghị otu a na-ahụkarị. Nke a na-ezo aka na nnabata glucose na-arịa ya.

N'okwu a, ọkwa glucose ọnụ na-ebu ọnụ ga-adị n'okpuru 6.1 mmol / L, ma mgbe awa abụọ gachara nchịkwa glucose ọ ga-abụ 7.8 - 11.1 mmol / L. Nkọwa ahụ na-egosi ohere dị elu nke ọrịa shuga n'ọdịniihu. Ọdịdị nke ọrịa ahụ na-adabere n'ọtụtụ ihe ndị ọzọ. Ọ nwere aha nke ya - ọrịa shuga.

Enwere echiche nke ibu ọnụ glycemia. Nyocha ọkwa shuga maka afọ efu na ọbara na ọbara ọbara ebe a bụ 5.5 - 6.1 mmol / L, na elekere abụọ ka nchịkwa glucose gasịrị, ihe ngosi ahụ bụ ihe dị mma, ya bụ, ihe dịka 7.8 mmol / L. A na-ahụta ya dị ka ihe ndị dị ize ndụ maka inwekwu ọrịa shuga mellitus, mkpebi nke nwere ike ọ gaghị eme ozugbo.

Ibu ọnụ na-ezo aka enweghị nri ọ bụla ruo awa 8 ma ọ bụ karịa.

Ọnọdụ nke ịchọpụta glucose ọbara

Enwere ike iji nyocha ogo nke glucose na:

1. pathology nke adrenal gland, pituitary gland na thyroid gland,
2. nsogbu na ọrịa na imeju,
3. ọrịa shuga, n'agbanyeghị ụdị ya,
4. na-achọpụta nnabata glucose na ndị nwere ọrịa shuga,
5. ibu oke ibu
6. ọrịa shuga na ụmụ nwanyị dị ime,
7. mgbanwe mgbanwe glucose.

Ikwesiri ịmara na nkọwa ahụ chọrọ ịhapụ nri ruo elekere asatọ tupu nyocha. Ntụle ahụ kachasị mma iji nweta ọbara n'ụtụtụ. A na-apụkwa ihe karịrị oke ọgụ, ma anụ ahụ ma nke uche.

Mkpụrụ ọbara, ma ọ bụ n'ụzọ ọzọ, plasma, na - kewapụrụ sel n ’n’ime awa abụọ ka ewerechara ọbara. Na mgbakwunye, ịnwere ike iji tube pụrụ iche nke nwere ihe mgbochi glycolysis. Ọ bụrụ na emeghị ọnọdụ ndị a, mgbe ahụ, ihe atụghị anya na-abụghị eziokwu.

Nnyocha glucose ọbara gụnyere ụzọ ndị a:

• nyocha Choctometric, ọ dabere na ikike nke glucose iji weghachi nitrobenzene na nnu ọla,
• nyocha enzymatic, dịka ọmụmaatụ, usoro glucose oxidase;
• Usoro mmeghachi omume agba, usoro pụrụ iche gosipụtara na kpo oku nke carbohydrates.

Oxzọ glucose oxidase bụ nyocha nke ego shuga dị na mmamịrị na ọbara dị n’afọ na-enweghị isi. Usoro a dabere na mmeghachi nke glucose na glucose oxidase enzyme yana ịkpụpụta hydrogen peroxide, nke na-egbu orthotolidine n'oge peroxidase.

A na-atụnye ọnụọgụ glucose ọbara na-ebu ọnụ site na usoro photometric, ebe a na-eji ike agba na-atụnyere eserese nhazi.

Omumu ihe banyere ogwu gwaa ikpebi glucose:

1. n'ọbara venous, ebe ihe dị na nyocha ahụ bụ ọbara sitere na akwara. A na-eji nyocha ndị na-akpaghị aka,
2. n'ọbara di nma, ewee si na nkpisi aka ya Thezọ a na-ahụkarị, maka nyocha gị chọrọ obere ọbara (ụkpụrụ adịghị karịa 0.1 ml). A na - ejikwa ngwa pụrụ iche rụọ ụlọ nyocha ahụ n'ụlọ.

Zoro ezo (subclinical) n'ụdị metabolism na-emebi ike

Iji chọpụta ihe zoro ezo, ya bụ, ụdị subclinical nke nsogbu nsogbu nke carbohydrate, a na-eji nnabata nnabata glucose ma ọ bụ nnabata nnabata glucose na-agba ume.

Biko rịba ama: ọ bụrụ na ọkwa glucose plasma nke ọbara venous nke e weere na afọ efu karịrị nke 15 mmol / l, mgbe ahụ maka nchọpụta nke ọrịa shuga mellitus, achọrọghị nnabata glucose.

Gịnị bụ nnwale nnabata glucose na-agba ume?

Ọmụmụ nnabata glucose dị n’ime afọ na-enweghị ihe ọ bụla, na-eme ka ikewapụ ihe niile metụtara enweghị mgbaze, yana iwere carbohydrates n’ime obere eriri afọ.

N’ụbọchị atọ tupu ịmalite ọmụmụ ihe ahụ, a na-enye onye ọrịa ahụ nri nwere ihe dịka 150 g ụbọchị niile. A na-eme nyocha ahụ na afọ na-enweghị isi. A na-achịkwa glucose na intravenly na ọnụego anụ ahụ 0,5 g / n'arọ, n'ụdị usoro 25% n'ime otu ma ọ bụ abụọ.

Na plasma ọbara venous, a na-ekpebi itinye glucose ugboro asatọ: oge ​​1 na afọ efu, na oge ndị ọzọ 3, 5, 10, 20, 30, 45 na minit 60 mgbe a nyechara glucose ike. Enwere ike kpebie n ’insulin plasma insulin kwekọrọ na ya.

Nnukwu ọnụọgụ nke ọbara na-erugharị na-egosiputa ọ̀tụ̀tụ̀ glucose na-apụ n'anya ọbara mgbe ọ jisịrị ọbara. N'otu oge, ekpebie oge ọ ga-ewe iji belata ọkwa glucose ugboro abụọ.

Usoro pụrụ iche na-agbakọ ọnụọgụ a: K = 70 / T1 / 2, ebe T1 / 2 bụ ọnụọgụ nkeji achọrọ iji belata glucose ọbara ugboro abụọ, nkeji iri mgbe ọ nwesasịrị.

Y’oburu na ihe obula zuru oke, mgbe ahu ka ekpughere glucose di n’iru, obara obubu ibu ya rue elu di elu - rue 13.88 mmol / L. A na-ahụ ọkwa insulin dị elu na nkeji ise.

Ọkwa glucose na-alaghachi uru mbụ ya mgbe ihe dị ka nkeji 90 site na nyocha nke nyocha. Ka elekere abụọ gachara, glucose na - agbadata n'okpuru ntọala, ma mgbe awa atọ gachara, ọkwa ahụ na-alaghachi na ntọala.

Ihe ndị a na - akpata glucose dị n'okpuru:

• n'ime ndị nwere ọrịa shuga ọ dị n'okpuru 1.3. A na-achọpụta mkpokọta insulin nkeji ise mgbe mmalite nyocha ahụ,
• n’ebe ndị okenye dị ike nọ, ndị na-enweghị nsogbu ọrịrị na -agọnahụ nke carbohydrates, rashị karịrị 1.3.

Hypoglycemic na hyperglycemic coefficients

Hypoglycemia bụ usoro ọgwụgwọ nke na-agbasa n'ime glucose ọbara dị ala.

Hyperglycemia bụ akara ọrịa, nke na-egosi inwe ọnya afọ ojuju dị ukwuu n'ọbara.

Ọkwa dị elu na-apụta na ọrịa mellitus ọrịa shuga ma ọ bụ nsogbu ndị ọzọ nke usoro endocrine.

Enwere ike inweta ozi gbasara steeti carbohydrate mgbe agbakọchara ihe ngosi abụọ nke nyocha nnabata glucose:

• hyperglycemic ọnụọgụ bụ ruru nke glucose ogo n'otu awa, n'ọkwa ya na afọ efu,
• hypoglycemic ọnya bụ ruru nke glucose larịị 2 awa mgbe ịbanye n'ọkwa ya na afọ efu.

N'ime ndị ahụ dị mma, ọnụọgụ hypoglycemic nkịtị na-erughị 1.3, ọkwa hyperglycemic anaghị agafe 1.7.

Ọ bụrụ na ụkpụrụ dịkarịsịrị ala ma ọ dịkarịa ala otu ihe egosipụtara, nke a na-egosi na a na-ebelata nnabata glucose.

Glycosylated haemoglobin na ọkwa ya

A na-ezo aka na ụdị hemoglobin dị ka HbA1c. Nke a bụ haemoglobin, abanyela na mmiri ọgwụ na-adịghị enzymatic na monosaccharides, na, karịchaa, enwere glucose, nke dị n'ọbara.

N'ihi mmeghachi omume a, a na-etinye nsị monosaccharide na protein protein. Olu nke haemoglobin nke glycosylated na-apụta ozugbo na-adabere n'ọtụtụ shuga dị n'ọbara, yana oge oge mmekọrịta nke ihe glucose gluemo nwere.

Ọ bụ ya mere ọdịnaya glucose haemoglobin ji ekpebi ogo nke glucose dị n'ọbara ogologo oge, nke a pụrụ iji ya tụnyere ndụ nke mkpụrụ ndụ haemoglobin. Ọ dị ihe dị ka ọnwa atọ ma ọ bụ anọ.

Ebumnuche maka ikenye ọmụmụ ihe a:

1. nyocha na ịchọpụta ọrịa shuga,
2. ogologo oge nlebara anya banyere ọrịa a na ileba anya n’usoro ọgwụgwọ nke ndị nwere ọrịa shuga.
3. nyocha ọrịa shuga,
4. nyocha ndị ọzọ maka nnwale nnabata glucose dị ka akụkụ nke nchoputa nke ọrịa shuga ngwa ngwa ma ọ bụ ọnọdụ bu ọrịa ahụ ụzọ.
5. oria shuga n’oge ime.

Usoro na haemoglobin glycated na mmeghachi omume nke thiobarbituric acid sitere na 4.5 ruo 6, 1 molar pasent, dịka nyocha ahụ gosiri.

Ntughari nke nsonaazụ ya site na ndiiche na teknụzụ ụlọ nyocha na ọdịiche nke ndị mmadụ mụụrụ. Mkpebi siri ike, ebe ọ bụ na agbasawanyere n'ụkpụrụ ọbara ọbara. Yabụ, n'ime mmadụ abụọ nwere otu ọkwa shuga dị ala, ọ nwere ike iru 1%.

Increasekpụrụ na-abawanye mgbe:

1. ọrịa shuga mellitus na ọnọdụ ndị ọzọ nke ọrịa glucose na-akpata.
2. na-ekpebi ọkwa nke ụgwọ: site na 5.5 ruo 8% - ọrịa shuga kwụrụ ụgwọ, site na 8 ruo 10% - ọrịa na-akwụghachi ụgwọ nke ọma, site na 10 ruo 12% - na-akwụghachi ụgwọ ọrịa na-akwụghachi ụgwọ. Ọ bụrụ na pasent ahụ karịrị 12, mgbe ahụ nke a bụ ọrịa shuga na-enweghị atụ.
3. ụkọ ígwè
4. ogwugwu
5. mmụba ụgha n'ihi oke ịba ụba nwa ebu n'afọ.

Decreasekpụrụ ga-ebelata mgbe:

• ọbara ọgbụgba
• hemolytic anaemia,
• mmịnye ọbara
• hypoglycemia.