ỌRỊA SHUGA STEROID - GỊNỊ KA Ọ BỤ? ORIA NA ARU OGWU

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N’ụdị ọgwụgwọ ya, ọrịa shuga steroid bụ insulin-based diabetes mellitus (DM 1), mana ọ jikọtara njirimara nke ụdị na nke mbụ na nke abụọ.

Ihe kpatara ọdịdị ahụ bụ ọnụnọ ogologo oge na ọbara nke nnukwu corticosteroids (homonụ nke adrenal cortex mepụtara), nke na-eduga na-adịghị mma nke pancreas n'ihi mmebi nke mkpụrụ ndụ ya.

Symptomatology

Otu akụkụ nke ọrịa shuga steroid, nke a na-akpọkwa ọrịa shuga, bụ ogo dị ala nke mgbaàmà ya.

N'oge mbido ọrịa ahụ, ịba ụba nke corticosteroids na-akpata mbibi mkpụrụ ndụ nke endocrine pancreas, mana mmepụta insulin ka na-aga n'ihu. Nke a bụ ihe isi ike - oria ahụ amalitelarị ịbanye, mana mgbaàmà ahụ ka na-esighi ike ma onye ọrịa ahụ adịghị ọsọ enyemaka ịchọ enyemaka ahụike.

Site na nkwụsị zuru oke nke mwepụta insulin, ihe mgbaàmà e ji mara ọrịa shuga nkịtị na-apụta:

Polyuria
Polydipsia;
Adịghị Ike
Ike ọgwụgwụ;
Ọnọdụ dara ogbenye n'ozuzu.

Mbelata nke mberede abụghị ihe na-arịa ọrịa shuga mellitus, dịkwa ka mgbanwe mberede na glycemia. Ọta shuga na acetone n'ime mmiri a gụrụ (ọbara na mmamịrị) na-abụkarị ihe kwesịrị. Nke a na - eme ka ọ sie ike ịme nchọpụta ziri ezi.

Ihe kpatara ọdịdị ahụ

Ọrịa shuga steroid na-aputa ihe n'ihi oke corticosteroids n'ime ọbara mmadụ. Ihe kpatara ngafe a nwere ike bụrụ nke na-agwụ ike.

N'ihe na - akpata endogenous, ịba ụba homonụ nwere ike ịpụta n'ihi ọrịa nke usoro endocrine. Na mkpochapu - ịba mmiri homonụ na - apụta mgbe ejiri ọgwụ glucocorticosteroid ruo ogologo oge.

Iju Okwu

Ọrịa shuga steroid nwere ike ime ka:

Thiazide diuretics (Ezidrex, Hypothiazide).
Ọgwụ ndị a na-eji na ọgwụgwọ nke mmeghachi omume nfụkasị, polyarthritis, diphtheria, oyi baa, fever typhoid, mononucleosis na-efe efe na ọtụtụ ọrịa ndị ọzọ, gụnyere ndị autoimmune. Udi ogwu a gunyere Betaspan, Dexamethasone, Prednisolone, Dexon, Anaprilin.
Ọgwụ mgbochi ọgụ ejiri mee mgbe akwara gbasara akụrụ.
Ọgwụ mgbochi afọ ime.

Ihe ndị na-akpata ihe arụ

Mmebi nke ọnya ọgbụgba na-emetụta ọria nke anụ ahụ na akwara nke anụ ahụ na insulin. N'ime ọrịa ndị dị otú ahụ, ọrịa Hisenko-Cushing na-abụkarị ndị na-ezute, nke a na-egosipụta site na ịtionụbiga mmiri ókè nke mmiri cortisol site na cortex adrenal.

Ọrịa dị otú ahụ na-egosipụtakarị onwe ya megide ọrịa nke Hisenko-Cushing, nke dị iche na ọrịa ahụ na hyperfunction nke kortex adrenal na-amalite nke ugboro abụọ.

Isi ihe kpatara ọrịa ahụ bụ microadenoma nke pituitary.

Ọrịa ili (ihe ọxicụ goụ goiter), ọrịa kansa nke thyroid na-eme ka mmiri ọgwụ insulin na-ebelata ma na-etinyekwu ọbara ọbara, nwekwara ike ibute mmepe nke ọrịa shuga.

Dị Mkpa! Ọ bụrụ na n'oge nchịkwa nke glucocorticoid ọgwụ n'ime ndị ọrịa na-emegharị metabolism metabolism na ahụ, a ga-ekpochapụ ngafe nke homons site na kagbuo ojiji nke ọgwụ na iji dochie ọgwụ analogues na-adịghị ize ndụ.

Ìgwè Ewu

A dịghị ehibe ọrịa shuga steroid na ndị ọrịa niile na-a medicationsụ ọgwụ corticosteroid. Enwere ụfọdụ ihe na-eme ka o sie ike ike ịmalite ụdị ọrịa a:

mkpụrụ ndụ ihe nketa;

Ibu ibu;
Hypodynamia;
Oriri na-adighi nma.

Ihe ọghọm nke ibute ọrịa shuga na-abawanye mgbe ụfọdụ ma ọ bụrụ na enwere mkpụrụ ndụ ihe nketa nke nne na nna ọrịa nwere akụkọ banyere ọrịa ahụ.

Ibu ibu gabigara ókè, nke nwekwara ike ịpụta n’ihi arụghị ọrụ nke anụ ahụ, na-eduga n’ịbawanye ụba nke insulinoreactive insulin, lipids, cholesterol, glucose, ma mebie ọbara mgbali. Site na mmụba na nchịkọta anụ ahụ, nke a na-agbakọ site na ịkekọrịta ibu site na nha nke ibu na mita, ruo 27 n'arọ / m2, nke a na-eduga n'ịbelata ịdị mma nke anụ ahụ na insulin.

Ọnụọgụ dị mma nke shuga (shuga ụlọ ọrụ, mmanụ a honeyụ), carbohydrates dị mfe na mbelata protein na nri ahụ na-emebi usoro metabolic na ahụ, nke nwere ike ibute oke ibu.

Diagnostics

Ihe mgbagwoju anya nke ichoputa oria a bu na ihe ngosiputa nke anara anwansi na mmamiri na-apughi igabiga usoro iwu. Accuratezọ nchọpụta ziri ezi karịa bụ nnabata nnabata glucose, nke na-ekpebi ọnụnọ nke ọrịa shuga.

Enwere ike ịchọpụta nrịanrịa nke ọrịa shuga mellitus site na ịba ụba glucose ọbara site na 6 mmol / L na afọ efu na 11 mmol / L mgbe ejiri ngwakọta gluu rụọ ọrụ. Mgbe ahụ, a chọpụta ụdị ya.

Iji chọpụta shuga steroid, a na-eme nnwale ndị ọzọ: 17-ketosteroids na 17-hydroxycorticosteroids na mmamịrị, ule ọbara maka ọkwa nke homonụ nke adrenal cortex, pituitary gland.

Diagnozọ nchọpụta dị mkpa bụ nnwale ọbara biochemical, ya bụ, ndị na - egosi ya dịka glucose, haemoglobin glycated, insulin, C-peptide, lipoproteins, triglycerides, fructosamine, peptide.

Ọgwụgwọ

A na-agwọ ọrịa shuga Steroid dịka otu iwu ahụ dị ka ụdị ọrịa shuga nke 2 yana njirisi nke ụgwọ ga-abụ otu.

Ọgwụ dị irè maka ọrịa shuga steroid bụ ndị a:

Mwepu corticosteroids;
Nlekọta insulin;
Nri nri;
Drugsakingụ ọgwụ antidiabetic;
Ihe ogwugwo.

Site n'ọdịdị nke ọrịa ahụ (iji glucocorticoids), ọ dị mkpa ịkwụsị nchịkwa ha wee họrọ analogues na-enweghị nchebe. Usoro ọgwụgwọ ọzọ bụ nri nri, iji ọgwụ hypoglycemic na ọgwụ insulin ọgwụ.

Site na hypercorticism endogenous, mgbe a na-eme ka ọrịa shuga steroid site na-adịghị mma nke ahụ n'onwe ya, a na-eme ihe ndị a na-awa ahụ, nke gụnyere iwepu anụ ahụ gabigara ókè.

Ojiji nke ọgwụ antidiabet kwesịrị ka agwakọta ya na insulin insulin, ma ọ bụghị ya, hypoglycemic mmetụta nke nkuchi ha ga-adị obere ma ọ bụ na-anọghị kpamkpam. Nke a bụ n'ihi eziokwu ahụ bụ na insulin na-enye ohere maka oge ụfọdụ iji rụọ ọrụ mkpụrụ ndụ beta ma mee ka ha nwee ike iweghachi ọrụ nzuzo ha.

Nri nri a na - enye ha n ’carbohydrate dị ala gụnyere ịbelata ego nke carbohydrates na -eme kwa ụbọchị ma nwekwuo oriri na protein na abụba oriri. N’ihi ịgbaso nri dị otú ahụ, ọdịmma mmadụ n’onwe ya na-emeziwanye, mkpa insulin na ọgwụ belata anụ ahụ na-ebelata, a na-ebelata ọ̀tụ̀tụ̀ shuga dị na mgbe a riri nri.

Ọgwụ shuga dị ala enweghị ike ịgwọ ọrịa shuga kpamkpam, oriri ha na-eduga n'ịdị mma ma nwekwuo arụmọrụ.

Nkewa ogwu

Ọgwụ shuga na-abịa n’otu dị iche iche:

Ngwurugwu Sulfonylurea;
Thiazolidinediones;
Alfa glucosidase na-egbochi;
Meglitinides;
Incretinomimetics.

Ngwunye nke sulfonylureas bụ nke a na-ejikarị maka ọgwụgwọ nke ụdị ọrịa shuga 2, ya mere na-arịa ọrịa shuga steroid. Usoro nke omume ha bụ iji mee ka mkpụrụ ndụ B nke mkpụrụ ndụ endocrine dị na ya pụta, n'ihi nsonaazụ ya na ụba insulin.

Ndi dibia bekee n’eweta ndenye ogwu dika Glycvidon, Chlorpropamide, Maninil, Tolbutamide, Glipizide.

Meglitinides (Nateglinide, Repaglinide) na-abawanye mmepụta insulin na ọkwa glucose dị ala.

Biguanides (Bagomet, Metformin, Siofor, Glucofage) - ọgwụ nke ebumnuche ya bụ igbochi mmepụta glucose (gluconeogenesis) ma melite usoro nke ojiji. Ọ bụrụ na inje insulin adịghị, mmetụta nke biguanides apụtaghị.

Thiazolidinediones ma ọ bụ glitazone (Pioglitazone na Rosiglitazone) na-eme ka uru ahụ dịkwuo elu, anụ ahụ adipose na imeju na insulin, site na ịgbalite ndị na-anabata ya, ma na-emekwa ka metabolism dị ọcha.

Ndị na-egbochi Alfa-glucosidase (Voglibosis, Glucobay, Miglitol) na-akụda mmebi nke saccharides, na -ebelata nguzobe na ịmịkọta glucose na eriri afọ.

Mmụba dị elu (Liraglutid, Exenatide, Sitagliptin, Saksagliptin) bụ klaasị ọhụrụ nke ọgwụ antidiabetic, usoro nke ịdabere na akụrụngwa nke ọgwụ ndị dị na mmiri, homonụ nke ụfọdụ ụdị obere mkpụrụ ndụ eriri afọ gachara. Nri ha na - eme ka nnabata nke insulin lara ala, belata ogo glucose.

Ihe e ji mara ọrịa steroid bụ ihe kwụsiri ike na ụzọ ndụ ọfụma. Treatmentgwọ ụdị ọrịa ahụ kwesịrị ịbụ nke zuru oke ma gụnye ọ bụghị naanị inje insulin na ojiji nke ịbelata shuga, kamakwa nri na usoro ndụ.

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