Ka mofuta oa eona oa bongaka, lefu la tsoekere la steroid ke mofuta oa "mellitus" oa lefu la tsoekere le amanang le insulin, empa le lona le kopanya litšobotsi tsa mofuta oa pele le oa bobeli.
Lebaka la ponahalo ke ho ba teng ha nako e telele maling a bongata bo boholo ba li-corticosteroids (lihomone tse hlahisoang ke adrenal cortex), tse lebisang ho sebetseng hantle hoa manyeme ka lebaka la tšenyo ea lisele tsa ona.
Matšoao a matšoao
Mehatong ea pele ea lefu lena, corticosteroids e ngata e baka lisele tsa "pocreas" ea endocrine, empa tlhahiso ea "insulin" e ntse e tsoela pele. Bjo ke bona bo boima - lefu lena le se le ntse le fetoha ka botlalo, empa matšoao a ntse a fokola haholo mme mokuli ha a potlakela ho kopa thuso ea bongaka.
Ka ho emisa ka botlalo ha insulin, matšoao a lefu la tsoekere le tloaelehileng a hlaha:
- Polyuria
- Polydipsia;
- Bofokoli
- Mokhathala;
- Boemo bo bobe ka kakaretso.
Ho fokotsa boima ba 'mele ka tšohanyetso ha se ntho e tloaelehileng ho mellitus ea lefu la tsoekere, joalo ka liphetoho tsa tšohanyetso glycemia. Ho bokellana ha tsoekere le acetone metsing a ithutoang a 'mele (mali le moroto) hangata ho atamelana haholo. Sena se etsa hore ho be thata ho fumana tlhahlobo e nepahetseng.
Mabaka a ponahalo
Lefu la tsoekere la Steroid le hlaha ka lebaka la ho ata ha corticosteroids maling a motho. Mabaka a sena se fetelletseng e ka ba a exo native and endo native.
Ka lisosa tsa Endo native, li-hormone tse ngata li ka hlaha ka lebaka la mafu a tsamaiso ea endocrine. Ka exo native - ho ata ha lihormone ho etsahala kamora ts'ebeliso ea nako e telele ea lithethefatsi tsa glucocorticosteroid.
Exo native
Lefu la tsoekere la Steroid le ka baka:
- Thiazide diuretics (Ezidrex, Hypothiazide).
- Lithethefatsi tse sebelisoang kalafo ea methapo ea methapo, polyarthritis, diphtheria, pneumonia, typhoid fever, tšoaetso ea mononucleosis le mafu a mang a mangata, ho kenyeletsa le autoimmune. Mokhahlelo ona oa lithethefatsi o kenyelletsa Betaspan, Dexamethasone, Prednisolone, Dexon, Anaprilin.
- Lithethefatsi tse khahlanong le ho ruruha tse sebelisitsoeng kamora ho buoa ha meno ho pepa.
- Lipilisi tsa thibelo ea bokhachane.
Lisosa tsa tlhaho
Ho tlatlapuoa ha tšoelesa ea pituitary ho ama hampe ho hanyetsa ha lisele tsa mmele le lisele tsa mmele ho insulin. Har'a maemo a joalo a pathological, Itsenko-Cushing syndrome hangata e kopana le eona, e khetholloang ka ho pepeseha ho hoholo ha cortisol ea hormone ke adrenal cortex.
Lefu lena le joalo le iponahatsa khahlano le semelo sa lefu la Itsenko-Cushing, le phapang ea lona ka hore hyperfunction ea adrenal cortex e hlaha lekhetlo la bobeli.
Sesosa se ka sehloohong sa lefu lena ke pituitary microadenoma.
Lefu la Graves (lefuba le nang le chefo), lefu la qoqotho ea autoimmune leo tsoalo ea lona e tsoang le insulin le ho eketseha ha tsoekere ea mali le lona le ka lebisang ho holiseng lefu la tsoekere la lithethefatsi.
Sehlopha sa likotsi
Lefu la tsoekere la Steroid ha lea thehoa ho bakuli bohle ba sebelisang meriana ea corticosteroid. Ho na le lintlha tse eketsang monyetla oa ho ba le mofuta ona oa lefu:
tlhaho ea tlhaho;
- Boima bo feteletseng;
- Hypodynamia;
- Phepo e fosahetseng.
Boima bo feteletseng, bo ka boela ba hlaha ka lebaka la ho ikoetlisa 'meleng, ho lebisa ho eketseha ha mali a insulin e sa sebetseng, lipids, k'holeseterole, tsoekere, le tlolo ea khatello ea mali. Ka keketseho ea index ea boima ba 'mele, e baloang ka ho arola boima ka sekala sa kholo ka kholo ea limithara, ho isa ho 27 kg / m2, sena se lebisa ho fokotseha ha kutloisiso ea li-tishu ho insulin.
Bohlokoa ba tsoekere e hloekileng, e nkoang habonolo (tsoekere ea indasteri, mahe a linotsi), lik'habohaedreite tse bonolo le ho fokotseha ha protheine lijong li sitisa mekhoa ea metabolic 'meleng, e ka bakang botenya.
Ts'oaetso
Ho rarahana ha ts'oaetso ea lefu lena ke hore matšoao a tlhahlobo ea mali le urine a ka feta hofeta ka litekanyetso tse behiloeng. Mokhoa o nepahetseng haholoanyane oa tlhahlobo ea tlhahlobo ea tsoekere ke ona o khethollang boteng ba prediabetes.
Tlhahlobo ea tsoekere ea lefu la tsoekere e ka etsoa ka ho eketsa tsoekere ea mali ho tloha 6 mmol / L ka mpeng e se nang letho ho isa ho 11 mmol / L kamora ho laolla ka tharollo ea glucose. Ebe mofuta oa eona oa fumanoa.
Ho tseba lefu la tsoekere la steroid, ho etsoa liteko tse eketsehileng: 17-ketosteroids le 17-hydroxycorticosteroids ka moroto, liteko tsa mali bakeng sa boemo ba li-hormone bo hlahisoang ke adrenal cortex, gland ea pituitary.
Phekolo
Lefu la tsoekere la steroid le alafshoa ho latela melao e tšoanang le lefu la tsoekere la mofuta oa 2 le litekanyetso tsa puseletso li joalo.
Phekolo e sebetsang ea lefu la tsoekere la steroid ke e latelang:
- Ho tlosoa ha corticosteroids;
- Tsamaiso ea insulin;
- Lijoa;
- Ho sebelisa litlhare tse loantšang lefu la tsoekere;
- Ts'ebetso ea ts'ebetso.
Ka mofuta oa kantle ho nts'etsopele ea lefu lena (ts'ebeliso ea li-glucocorticoids), hoa hlokahala ho emisa tšebetso ea bona mme ba khetha li-analogue tse sireletsehileng. Mehato e latelang ea phekolo ke lijo, tšebeliso ea li-acocoglycemic agents le litekanyetso tsa kalafo ea insulin.
Ka endo native hypercorticism, ha lefu la tsoekere la steroid le bakoa ke ho se sebetse hantle ha 'mele, ho kenella lipakeng ho etsoa hangata, tse kenyelletsang ho tlosa lisele tse ngata maling a adrenal.
Ts'ebeliso ea lithethefatsi tsa antidiabetic e lokela ho kopantsoe le liente tsa insulin, ho seng joalo phello ea hypoglycemic ea ho amoheloa ha bona e tla ba e fokolang kapa e sa be teng ka botlalo. Sena se bakoa ke taba ea hore insulin e lumella nako e itseng ho tsamaisa lisele tsa beta le ho li nolofalletsa ho khutlisa mesebetsi ea tsona ea sekhukhu.
Lijo tse nang le lik'habohaedreite tse tlase li kenyelletsa ho fokotsa bongata ba lik'habohaedreite tse nooang ka letsatsi le ho eketsa phepelo ea liprotheine le mafura a meroho. Ka lebaka la ho latela lijo tse joalo, bophelo bo botle ba motho bo ea ntlafala, tlhoko ea 'mele ea lithethefatsi tse theolelang tsoekere le ea theoha, mme maemo a tsoekere ka mor'a ho ja a fokotsoa.
Mokhahlelo oa lithethefatsi
Lithethefatsi tse theolelang tsoekere li tla ka lihlopha tse 'maloa:
- Lintho tse tsoang ho Sulfonylurea;
- Thiazolidinediones;
- Alfa glucosidase inhibitors;
- Meglitinides;
- Incretinomimetics.
Liphetoho tsa sulfonylureas hangata li sebelisoa bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2, le lefu la tsoekere la steroid. Mokhoa oa tšebetso ea bona ke ho susumetsa lisele tsa B tsa karolo ea "pancreas" ea "pancreas", ka lebaka la tsona ho nang le ts'usumetso le tlhahiso e eketsehileng ea insulin.
Lingaka tse neng li le teng li fana ka litlhare tse kang Glycvidon, Chlorpropamide, Maninil, Tolbutamide, Glipizide.
Meglitinides (Nateglinide, Repaglinide) e eketsa tlhahiso ea insulin le litekanyetso tse tlase tsa tsoekere.
Biguanides (Bagomet, Metformin, Siofor, Glucofage) - lithethefatsi tseo ketso ea tsona e reretsoeng ho thibela tlhahiso ea tsoekere (gluconeogeneis) le ho ntlafatsa ts'ebetso ea ts'ebeliso ea eona. Ha ho na le ente ea insulin, phello ea li-biguanides ha e bonahale.
Li-Thiazolidinediones kapa glitazone (Pioglitazone le Rosiglitazone) li matlafatsa kutloisiso ea mesifa, lithaelese tsa adipose le sebete ho insulin, ka ho kenya tšebetsong li-receptor tsa tsona, hape le ho ntlafatsa metabolism ea lipid.
Alpha-glucosidase inhibitors (Voglibosis, Glucobay, Miglitol) e fokotsa ho senyeha ha li-saccharides, e fokotsa sebopeho le ho monya ha tsoekere ka mpeng.
Keketseho ea "cincinomimetics "(Liraglutid, Exenatide, Sitagliptin, Saksagliptin) ke sehlopha se secha sa lithethefatsi tse khahlanong le lefu la tsoekere, mohato oa ts'ebetso o thehiloeng ho thepa ea li-insretin - li-hormone tse hlahisitsoeng ke mefuta e meng ea lisele tse nyane tsa mala ka mor'a ho ja. Ho kenella ha bona ho ntlafatsa ho tsoa ha insulin, ho fokotsa litekanyetso tsa tsoekere.
Lefu la tsoekere la Steroid le tšoauoa ka tsela e tsitsitseng le e sa nepahalang. Phekolo ea lefu le joalo e lokela ho ba e akaretsang mme e kenyeletse eseng feela liente tsa insulin le tšebeliso ea lithethefatsi tse fokotsang tsoekere, empa hape le mokhoa oa ho ja le mokhoa o mafolofolo.
