Ka hanong la motho, tshilo ea glycogen le starch e qala tlasa ts'usumetso ea amylase ea salivary. Tlas'a tšusumetso ea li-amylase ka mpeng e nyane, ho hlahella lesapo la ho qetela la polysaccharides ho maltose.
Likahare tse ka har'a lero la mala la palo e kholo ea li-hydrolases - li-enzyme tse hlakolang sucrose, maltose le lactose (disaccharides) ho fructose, galactose le glucose (monosaccharides).
Galactose le glucose li kenella ka potlako ke microvilli ea mala a manyane, li kena maling le ho fihlela sebete.
Tekano le phapang ea tsoekere e bonoa ho plasma, le serum ea mali, e ajoa ka mokhoa o lekanang lipakeng tsa likarolo tse thehiloeng le plasma.
Glucose ke sesupo se ka sehloohong sa metabolism ea carbohydrate, 'me lihlahisoa tsa carbohydrate ke:
- polysaccharides: starch le selulose,
- fructose le tsoekere
- sucrose le lactose,
- tsoekere e meng.
Tekanyetso ea tsoekere:
- bakeng sa masea a tlang pele ho nako, moelelo ke 1.1-3.33 mmol / l,
- bakeng sa masea a sa tsoa hlaha letsatsi le le leng 2.22-3.33 mmol / l,
- bakeng sa bana ba khoeli le khoeli 2.7-4.44 mmol / l,
- bakeng sa bana ba ka holimo ho lilemo tse hlano, 3.33-5.55 mmol / l,
- a le moholo ho fihlela ho 60 4.44-6.38 mmol / l,
- batho ba lilemo li 60 - se tloaelehileng ke 4.61-6.1 mmol / l.
Hypoglycemia e fuoa batho ba baholo haeba sethala sa glucose se sa fihle ho 3,3 mmol / L. Tsoekere e phahamisitsoeng (kapa maemong a mang esita le hyperglycemia) e ea beha haeba tlhahlobo e senola hore litaba tsa glucose li phahame ho feta 6.1 mmol / l.
Ho bohlokoa ho tseba hore tlolo ea metabolism ea carbohydrate e qala sebakeng leha e le sefe sa metabolism ea tsoekere. Sena se ka etsahala ha tsoekere e kenngoa ka mpeng ea tšilo ea lijo, e kenella ka mpeng e nyane kapa sethaleng sa metabolism ea lik'habohaedreite limeleng tsa motho.
Hyperglycemia kapa keketseho ea khatello ea tsoekere e ka hlahisoa ke:
- ho ferekanya kelello: ho tsuba ka potlako, khatello ea maikutlo, ho ikoetlisa ka ho lekaneng, maikutlo a seng monate, ho potlaka haholo ha adrenaline nakong ea ente,
- lefu la tsoekere ho batho ba lilemo tsohle,
- hemorrhage
- gigantism, acromegaly, thyrotooticosis, pheochromocytoma le li-pathologies tse ling tsa endocrine,
- mafu a pancreatic, ho etsa mohlala, pancreatitis e sa foleng kapa e hlobaetsang, cystic fibrosis, hemochromatosis le tumor ea manyeme,
- Maloetse a tsamaiso ea tšilo ea lijo, haholo-holo sebete le liphio,
- boteng ba li-antibodies ho li-insulin receptor,
- tšebeliso ea k'hafeine, thiazides, glucocorticoids le estrogens.
Hypoglycemia kapa ho fokotseha ha tsoekere e ka ba le:
- mathata a pancreatic: adenoma, carcinoma, hyperplasia, insulinoma, khaello ea glucagon,
- hypothyroidism, adrenogenital syndrome, lefu la Addison, hypopituitarism,
- ka lesea le hlahileng pele ho nako le tsoaloang ke mosali ea nang le lefu la tsoekere
- overdose ea insulin le li-agents tsa hypoglycemic,
- mafu a matla a sebete: carcinoma, cirrhosis, hemochromatosis, hepatitis,
- li-tumor tse mpe tse sa hlokeng ho ruruha: fibrosarcoma, mofetše oa mpa kapa lefu la adrenal,
- galactosemia, lefu la gyrke,
- mathata a fapaneng a autonomic, gastroenterostomy, post-gastroectomy, gastrointestinal motility disorder,
- Ho itima lijo nako e telele, lefu la malabsorption le mathata a mang a ho ja,
- chefo ka salicylates, arsenic, chloroform, antihistamines kapa joala,
- ho ikoetlisa ka matla le feberu,
- tšebeliso ea amphetamine, li-steroid le propranolol.
Ho tsa bongaka, ho na le mofuta o le mong o bohareng oa boiphihlelo, ha se nnete ea lefu la tsoekere, empa eseng tloaelo. Hona ho bua ka mamello e sa sebetseng ea tsoekere.
Maemong ana, boemo ba tsoekere bo potlakileng bo tla lula bo le ka tlase ho 6.1 mmol / L, 'me ka mor'a lihora tse peli ka mor'a ts'ebetso ea glucose e tla ba 7.8 - 11.1 mmol / L. Tlhaloso e bonts'a kholo e kholo ea lefu la tsoekere nakong e tlang. Ponahalo ea lefu lena e latela lintlha tse ling tse ngata. E na le lebitso la eona - prediabetes.
Ho na le mohopolo oa ho itima lijo glycemia. Tlhahlobo ea boemo ba tsoekere bakeng sa mpa e se nang letho maling le serum mona ke 5.5 - 6.1 mmol / L, 'me lihora tse peli kamora ho tsamaisoa ha glucose, sesupo ke se tloaelehileng, ke hore, hoo e ka bang 7.8 mmol / L. E boetse e nkuoa e le maemo a kotsi bakeng sa ho thehoa ha lefu la tsoekere haholoanyane, boikemisetso ba bona bo ka se keng ba etsahala hanghang.
Ho itima lijo ho bolela ho se be teng ha lijo bakeng sa lihora tse 8 kapa ho feta.
Menyetla ea ho khetholla tsoekere ea mali
Tekanyo ea tsoekere ea glucose e ka fuputsoa le:
- Psychology ea gland, gland
- likotsi le mafu a ka har'a sebete,
- lefu la tsoekere, ho sa tsotelehe mofuta oa lona,
- ho bona mamello ea tsoekere ho ba lekantsoeng ke lefu la tsoekere,
- ho nona haholo
- lefu la tsoekere ho basali baimana,
- liphetoho mamellong ea glucose.
O hloka ho tseba hore moelelo o hloka ho fana ka lijo bakeng sa lihora tse 8 pele ho tlhahlobo. Ho hlahlojoa hantle ho nkuoa hosane hoseng. Ho sithabela hohle, khatello ea maikutlo le ea kelello, le hona ha ho behelletsoe ka thoko.
Serum, kapa ka mantsoe a mang plasma, e arohantsoe le lisele ka nako ea lihora tse peli kamora hore sampole ea mali e nkuoe. Ntle le moo, o ka sebelisa tube e khethehileng e nang le li-inhibitors tsa glycolysis. Haeba maemo ana a sa khotsofatsoe, ho ka etsahala hore batho ba sa tsotelleng maikutlo.
Teko ea tsoekere ea mali e kenyelletsa mekhoa e latelang:
- lipatlisiso tsa reductometric, e ipapisitse le bokhoni ba tsoekere ho khutlisetsa letsoai la nitrobenzene le letsoai la koporo,
- Patlisiso ea enzymatic, mohlala, mokhoa oa glucose oxidase;
- mokhoa oa ho arabela ka mebala, mokhoa o ikhethileng o boletsoeng ho futhumatsa ha lik'habohaedreite.
Mokhoa oa glucose oxidase ke tlhahlobo ea tsoekere ho moroto le mali ka mpeng e se nang letho. Mokhoa o thehiloe ho karabelo ea glucose oxidase encyme ea glucose oxidase ka sebopeho sa hydrogen peroxide, e leng oxidizing orthotolidine nakong ea peroxidase.
Khokahano ea tsoekere ea mali e potlakileng e baloa ka mokhoa oa lifoto, ha botebo ba mmala bo bapisoa le graph graph.
Tloaelo ea bongaka e ka khetholla tsoekere:
- maling a venous, moo lintho tse tsoang tlhahlobisong e le mali a tsoang mothapong. Bahlahlobi ba ikemetseng ba sebelisoa,
- maling a capillary, a ntšitsoeng monoaneng. Mokhoa o atileng haholo, bakeng sa tlhahlobo u hloka mali a manyane (moelelo o sa feteng 0,1 ml). Tshekatsheko e boetse e etsoa lapeng ka lisebelisoa tse khethehileng - glucometer.
Mefuta e patehileng (subclinical) ea metabolism e sitisang mmele
Ho supa tse patiloeng, ke hore, mefuta e fokolang ea likotsi tsa metabolism ea carbohydrate, ho sebelisoa tlhahlobo ea mamello ea glucose kapa tlhahlobo ea mamello ea glucose.
Ka kopo hlokomela: haeba boemo ba glucose ea mali a venous a nkiloeng ka mpeng e se nang letho bo phahame ho feta 15 mmol / l, joale bakeng sa ho sibolla lefu la tsoekere, ho sa hlokahale tsoekere ea tsoekere.
Teko ea ho mamella glucose e kenang ka hare ke eng?
Phuputso e mamellehang ea tsoekere ea "glucose" e kenang ka mpeng e se nang letho, e etsa hore e khone ho qhelela ka thoko ntho e ngoe le e ngoe e amanang le ho haella ha lijo, hammoho le ho kenngoa ha lik'habohaedreite ka mpeng e nyane.
Bakeng sa matsatsi a mararo pele thuto e qala, mokuli o fuoa lijo tse ka bang 150 g letsatsi le letsatsi. Tlhahlobo e etsoa ka mpeng e se nang letho. Glucose e tsamaisoa kahare ka sekhahla sa boima ba 0.5 g / kg, ka tsela ea tharollo ea 25% ka motsotso o le mong kapa tse peli.
Ka plasma ea venous ea mali, khatello ea tsoekere e ikemetse ka makhetlo a 8: nako e le ngoe ka mpeng e se nang letho, 'me makhetlo a phomolo makhetlo a 3, 5, 10, 20, 30, 45 le 60 kamora hore tsoekere e fanoe kahare. Tekanyo ea "insulin" ea mali e ka tsejoa ka ho tšoana.
Ho lekana hoa tšebeliso ea mali ho bonts'a tekanyo ea tsoekere ea mali maling ka mor'a ts'ebetso ea eona e kenelletseng. Ka nako e ts'oanang, nako e nkang ho fokotsa boemo ba tsoekere ka makhetlo a 2 e ikemiselitse.
Foromo e ikhethileng e bala phetheho ena: K = 70 / T1 / 2, moo T1 / 2 e le palo ea metsotso e hlokahalang ho fokotsa tsoekere ea mali ka makhetlo a 2, metsotso e 10 kamora ho kenngoa ha eona.
Haeba ntho e ngoe le e ngoe e ka har'a meeli e tloaelehileng, joale metsotso e 'maloa ka mor'a hore tsoekere e qale ho kenngoa, tekanyo ea mali a eona a potlakileng e fihla tekanyo e phahameng - ho fihla ho 13.88 mmol / L Litekanyetso tsa insulin ea peak li bonoa metsotsong e mehlano ea pele.
Sekhahla sa tsoekere se khutlela boleng ba sona ba pele kamora metsotso e ka bang 90 ho tloha ha ho qala tlhahlobo. Kamora lihora tse peli, sethala sa glucose se theoha ka tlase ho motheo, mme kamora lihora tse 3, boemo bo khutlela mokokotlong.
Lintho tse latelang tsa tsoekere lia fumaneha:
- bathong ba nang le lefu la tsoekere ba ka tlase ho 1.3. Peak insulin mahlaseli a fumanoa metsotso e mehlano kamora ho qala ha tlhahlobo.
- ho batho ba baholo ba phetseng hantle ba se nang mathata a metabolic a lik'habohaedreite, karo-karolelano ena e kholo ho feta 1.3.
Hypoglycemic le hyperglycemic coefficients
Hypoglycemia ke ts'ebetso ea methapo e fetolelang ho glucose e tlase ea mali.
Hyperglycemia ke lets'oao la kliniki, le bonts'ang dikahare tse phahameng tsa tsoekere e le boima ba serum.
Karolo e phahameng e hlaha le lefu la tsoekere kapa mafu a mang a tsamaiso ea endocrine.
Tlhahisoleseling ka boemo ba metabolism ea carbohydrate e ka fumaneha kamora ho bala matšoao a mabeli a lipatlisiso tsa mamello ea glucose:
- Coergine ea hyperglycemic ke tekanyo ea tekanyo ea tsoekere ka hora, ho fihla boemong ba eona ka mpeng e se nang letho.
- Tekanyo ea hypoglycemic ke karolelano ea tekanyo ea tsoekere ka lihora tse 2 kamora ho kenya boemo ba eona ka mpeng e se nang letho.
Ho batho ba phetseng hantle, coeffnty e tloaelehileng ea "hypoglycemic" e tlase ho 1,3, mme boemo ba hyperglycemic ha bo fetelle ka holimo ho 1.7.
Haeba boleng bo tloaelehileng ba bonyane ba letšoao le le leng bo feta, joale sena se bontša hore mamello ea tsoekere e fokotsehile.
Glycosylated hemoglobin le boemo ba eona
Haemoglobin e joalo e bitsoa HbA1c. Sena ke hemoglobin, e kentseng karabelo e sa hlahiseng lik'hemik'hale ka li-monosaccharides, 'me, haholo-holo, ka glucose, e maling a potoloha.
Ka lebaka la karabelo ena, masala a monosaccharide a kenngoa molek'hule ea protheine. Bophahamo ba hemoglobin ea glycosylated e hlahang ka kotloloho e shebane le ho kenella ha tsoekere maling, le hore na ho na le nako e kae ea ho sebelisana ha tharollo e nang le tsoekere le hemoglobin.
Ke ka lebaka leo litaba tsa hemoglobin ea glycated e khethollang tekanyetso ea tsoekere maling maling ka nako e telele, e ka bapisoang le nako ea molek'hule ea hemoglobin. E ka ba likhoeli tse tharo kapa tse 'ne.
Mabaka a ho abela thuto:
- Ho hlahlobisisa le lefu la tsoekere,
- ho lekola lefu lena le nako e telele le ho hlokomela kalafo ea batho ba nang le lefu la tsoekere,
- tekolo ea matšeliso a lefu la tsoekere,
- tlhatlhobo e eketsehileng litekong tsa mamello ea tsoekere e le karolo ea tlhahlobo ea lefu la tsoekere le liehang kapa boemo bo ka pele ho lefu lena.
- lefu la tsoekere la morao nakong ea kemolo.
Tekanyetso le boemo ba hemoglobin e glycated ha a sebetsana le thiobarbituric acid e tsoa ho 4,5 ho isa ho 6, 1% molar, joalo ka ha tshekatsheko e bontša.
Tlhaloso ea sephetho e kopantsoe ke phapang ea mahlale a laboratori le liphapang tsa batho ba ithutileng. Boikemisetso bo thata, hobane ho na le ho ata ka litekanyetso tsa hemoglobin. Kahoo, ho batho ba babeli ba nang le tekanyo e lekanang ea tsoekere ea mali, e ka fihla 1%.
Melao ea boitšoaro e eketseha ha:
- lefu la tsoekere le maemo a mang a tšoauoa ka mamello ea tsoekere e maling,
- ho lekola boemo ba puseletso: ho tloha ho 5,5 ho isa ho 8% - lefu la tsoekere le lefisitsoeng, ho tloha ho 8 ho isa ho 10% - lefu le fumaneng hantle, ho tloha ho 10 ho isa ho 12% - lefu le lefsitsoeng ka mokhoa o lekanyelitsoeng. Haeba peresente e le kholo ho feta 12, joale sena ke lefu la tsoekere le sa lefelloeng.
- khaello ea tšepe
- splenectomy
- keketseho ea bohata ka lebaka la khatello e phahameng ea "fetal hemoglobin"
Melao ea boitšoaro e fokotseha ha:
- ho tsoa mali
- anemia hemolytic
- tšelo ea mali
- hypoglycemia
