Glycated hemoglobin ke thuto ea bohlokoa ho fumanoeng ha lefu le kang lefu la tsoekere. E bontša glycemia e tloaelehileng ho motho likhoeli tse 3 pele ho tlhahlobo.
Ka lebaka la thuto ena, ho a khonahala ho tseba nts'etsopele ea ts'ebetso ea methapo methapong ea pele le kalafo e qalang ea nako.
Batho ba nang le lefu la tsoekere ba hloka ho lekola letšoao lena nako le nako ho lekola ts'ebetso ea maano a khethiloeng a kalafo, le phetoho ea eona haeba ho hlokahala.
Ts'ebetso e bontša?
Hemoglobin e nkuoa e le karolo ea bohlokoa ea lisele tse khubelu tsa mali, tse ikarabellang bakeng sa ho tsamaisa khase ea carbon dioxide le palo e hlokahalang ea oksijene liseleng.
Nakong ea ho kenella ha tsoekere ka membrane ea lisele tse khubelu tsa mali, ho hlaha karabelo e itseng. Liphetho tsa ts'ebetso ena ke glycated hemoglobin (HbA1c). Tekanyo ea pontšo ena e ipapisitse le khatello ea tsoekere maling.
Boleng ba letšoao bo hakanngoa bakeng sa likhoeli tse 3, hobane ka hare ho lisele tse khubelu tsa mali li tsitsitse matsatsi a sa feteng matsatsi a 120, ebe li qala ho nchafatsa butle-butle. Letšoao le lekantsoe e le liperesente.
Morero oa tlhahlobo:
- Lemoga lefu la tsoekere mehatong ea pele.
- Fumana hore na ho na le NTG (mamello ea tsoekere e senyehileng).
- Lekola tsoekere ho bakuli ba seng ba fumanoe ba na le lefu la tsoekere (mofuta oa 1 kapa 2).
- Sekaseka boemo ba mokuli mme, ha ho hlokahala, lokisa mofuta oa kalafo.
Teko ea mali ha e hloke tokiso e khethehileng. Ho hlahlojoa ho lumelloa ho nkoa eseng feela ka mpa e se nang letho, empa le ka mor'a lijo tsa hoseng. Ntle le moo, haeba motho a nka meriana e itseng, ha ho hlokahale hore o e hlakole pele ho thuto.
Leha ho le joalo, li-laboratori tse ngata li khothaletsa hore bakuli ba bona ba se ke ba ja lijo pele ho tlhahlobo e le ho qoba mathata a bakoang ke mali.
Bakuli ba nang le lefu la tsoekere ba lokela ho hlokomela li-hemoglobin tsa bona tsa glycosylated bonyane makhetlo a 2 ka selemo. Ho lekane hore motho ea phetseng hantle a hlahlobe letšoao hang ka selemo. Lebaka ke hobane litekanyo tsa glucose tse nang le glucometer li bontša glycemia feela ka nako e itseng. Ho tseba hore na boleng ba tsoekere bo fetoha joang kamora ho ja, lijo tse bobebe, khatello ea maikutlo kapa boikoetliso, ho hlokahala hore u etse mehato e phetoang.
Lintho tse lokelang ho hlahlojoa ke mali a venous kapa a capillary. Liphetho li kanna tsa ba li se li loketse letsatsi le hlahlamang kapa matsatsi a mararo kamora ho pepa, kaha ho latela laboratori ka kotloloho.
Mathata a hlahlobisiso:
- theko e phahameng ha e bapisoa le boikemisetso ba litekanyo tsa tsoekere ea mali;
- boleng bo fumanoeng bo ka ba bo fosahetseng haeba mokuli a e-na le phokolo ea mali kapa hemoglobinopathy;
- tlhahlobo e kanna ea isoa metseng eohle;
- ho na le kotsi ea phello ea livithamini E kapa C tse nkiloeng ke motho boemong ba hemoglobin ea glycosylated (e ka fokotsoa);
- lihormone tse phahameng tsa qoqotho li ka lebisa liphetho tse ntle tsa lipatlisiso.
Melao ea HbA1c
Glycosylated hemoglobin e tšoaea nako ea metabolism ea carbohydrate e etsahalang 'meleng oa motho. Ha e le tsoekere e phahameng ea mali, e eketsa boleng ba eona.
Lenane la sepheo la HbA1c - ho tloha 4% ho isa ho 6% - bakeng sa motho ea phetseng hantle. Boleng bofe kapa bofe ba letšoao le oelang ka har'a meeli ena bo nkoa e le ntho e tloaelehileng ho motho ea phetseng hantle. Ho kheloha hoa sephetho sa hemoglobin e tsoang glycated ho tloha ho tloaelo ho ea ho e kholo (e nang le lefu la tsoekere) kapa lehlakoreng le fokolang ke pathology mme e hloka ho hlahlojoa ka botlalo ka bothata.
Phello ea HbA1c ka bongata ba 6% kapa 6.5% e bonts'a kotsi e kholo ea lefu la tsoekere (NVT). Boemong bo joalo, ho bohlokoa hore motho a se ke a fetoa ke monyetla oa ho qoba nts'etsopele ea lefu lena, kahoo o lokela ho nahanisisa ka lijo tsa hae mme a hlahlobe tlhahlobo kamora likhoeli tse 3, a ntse a tsoela pele ho lekola glycemia le glucometer nako ena kaofela.
Tlhahlobo ea boleng ba tlhahlobo ea mali eu lumella ho netefatsa kapa ho leleka lipelaelo ka boteng ba lefu la tsoekere ho motho. Phuputso ena e sebetsa hantle haholo maemong a belaelloang a lefu lena, ha lipontšo tsa eona li le sieo.
Chati ea Kamehla ea HbA1c:
| Glycated hemoglobin,% | Boleng bo tloaelehileng ba glycemia, mmol / l |
|---|---|
| 4,0 | 3,8 |
| 4,5 | 4,6 |
| 5,0 | 5,4 |
| 5,5 | 6,2 |
| 6,0 | 7,0 |
| 6,5 | 7,8 |
| 7,0 | 8,6 |
| 7,1 - 13,0 | 9,4 - 18,1 |
| 13,1 - 15,5 | 18,9 - 22,1 |
Ka bomalimabe, ho fumana sephetho sa HbA1c ha ho bolele hore boleng ba tsoekere ba mokuli bo lula bo le maemong a tloaelehileng. Ho theoha ka tšohanyetso kapa ho nyoloha ha maemo a tsoekere a etsahalang seoelo ha ho ame boleng bo bohareng ba hemoglobin ea glycosylated.
Ho bohlokoa ho utloisisa hore ka liphetho tsa HbA1c tse phahameng kamehla, motho ha a lokela ho leka ho ntlafatsa boleng ba eona ka nako e khuts'oane. Ho fokotseha ho hoholo ha letšoao ho tla ama pono hampe, ebile ho ka baka tahlehelo ea eona.
Leha taba ea hore 'mele o bona hypoglycemia khafetsa, le ho nyoloha ka bongata maemong a tsoekere, joalo ka boemo ba bona bo tloaelehileng, likepe li lula li fetoha le liphetoho tse e-so utloe. Ho qoba litlamorao tse joalo tse kotsi, bakuli ba lokela ho laola glycemia, ho qoba ho fetoha ha eona ka makhetlo a fetang 5 mmol / l.
Bakeng sa basali le banna
Ho kheloha ha letšoao ho tloaelehileng ho basali ho ka supa ponahalo ea le leng la mabaka a ka bang teng:
- nts'etsopele ea lefu la tsoekere la mofuta ofe kapa ofe;
- ho haella ha tšepe 'meleng;
- boteng ba ho hloleha ha rems;
- marako a fokolang a methapo;
- litlamorao tse amanang le ts'ebetso ea kalafo e fetileng.
Banna, ho fapana le thobalano e ntle, ba lokela ho etsa tlhahlobo ea HbA1c khafetsa, haholo kamora lilemo tse 40.
Tafoleng e tloaelehileng ea HbA1c ho basali:
| Mongoaha | Glycated Hemoglobin |
|---|---|
| Tlas'a 30 | 4.0% ho isa ho 5.0% |
| 30 ho isa ho 50 | 5.0% ho isa 7.0% |
| Ho feta 50 | Kaholimo ho 7.0% |
HbA1c tafoleng e tloaelehileng ho banna:
| Mongoaha | Glycated Hemoglobin |
|---|---|
| Tlas'a lilemo tse 30 | 4,5% ho isa ho 5.5% |
| Lilemo tse 30 ho isa ho tse 50 | 5.5% ho isa 6.5% |
| Ho feta lilemo tse 50 | Kaholimo ho 7.0% |
Ho se lumellane hofe kapa hofe le matšoao a fanoeng litafoleng e lokela ho ba lebaka la ho etsa tlhahlobo e eketsehileng le ho fumana lebaka.
Bakeng sa basali baimana
Nako ea ho ba le ngoana e amana le liphetoho tse ngata 'meleng oa mosali, ka hona, e ka ama le tsoekere ea glucose. Tabeng ena, litekanyetso tsa letšoao la hemoglobin ea glycosylated hanyane li fapana le boleng bo maemong a tloaelehileng.
Lethathamo la boleng ba HbA1c ho basali baimana:
| Mokhahlelo oa lilemo tsa moimana | Glycated hemoglobin,% |
|---|---|
| Nyane | 6,5 |
| Basali ba lilemo tse bohareng | 7,0 |
| Basali ba kaholimo ho lilemo tse 40 | 7,5 |
Tlhahlobo ea mali ho ea ka pontšo e lokela ho etsoa nako e le ngoe ho likhoeli tse 1.5 nakong ea kemolo. Boleng ba letšoao bo bontša nts'etsopele le boemo ba ha se mme oa ka moso feela, empa le ngoana, ka hona, liphapang leha e le life tse tsoang ho tloaelehileng li lokela ho arajoa ka potlako.
Tlhaloso ea sephetho:
- HbA1c e tlase e bonts'a ho haella ha tšepe 'meleng oa moimana. Bohlokoa bona ba letšoao bo ka baka nts'etsopele ea butle butle ea lesea.
- Boemo bo phahameng bo supa kotsi ea ho ba le lesea le leholo le ho hlaha ka thata.
Phuputso ea hemoglobin ea glycosylated ho basali baimana e senola mofuta oa lefu la tsoekere methating ea pele, e hlokang phekolo e nepahetseng le taolo e tlamang ea glycemic pele ho ngoana.
Matšoao a Kotsi ea Matšoao
Litekanyetso tse lumellanang tsa HbA1c li se li hlahisitsoe bakeng sa mekhahlelo e fapaneng ea bakuli, ka hona ho bohlokoa ho utloisisa hore na sena se bolelang. Ho fokotseha hoa letšoao ho boleng bo tloaelehileng ha ho hlokahale ho bakuli bohle, hobane ho ba bang ba bona, liphetho tse fetelletseng li tla ama hantle mokhoa oa pathological.
Sena se amahanngoa le kotsi e kholo ea hypoglycemia e nang le HbA1c e tloaelehileng, e leng kotsi haholo ho motho ea tsofetseng ea nang le mathata a teng a lefu la tsoekere. Ho fapana le hoo, bakuli ba banyenyane ba lokela ho boloka litekanyetso tsa bona tsa glycemia li le haufi le tse tloaelehileng.
Lethathamo la maemo a HbA1c ho latela lilemo tsa bakuli le mathata:
| Na ho na le kotsi ea mathata? | HbA1c ho bakuli ba banyenyane | HbA1c ho batho ba lilemo tse mahareng | HbA1c botsofaling |
|---|---|---|---|
| Kotsi ea mathata a mathata e fokolang. | Ka tlase ho 6.5% | Ha ho na ho feta 7.0% | Ha e holimo ho 7.5% |
| Kotsi e kholo ea hypoglycemia | Ka tlase ho 7.0% | Eseng ka tlase ho 7.5% | Eseng kaholimo ho 8,0% |
Liphetho tse Phahameng:
- nts'etsopele ea hyperglycemia (tsoekere e eketsehang ka holimo ho 5.5 mmol / l);
- ho ba teng ha khaello ea tšepe;
- ho tlosa lesapo la mokokotlo;
- tšenyo ea methapo;
- ho tla tlala ea oksijene ea litho le lisele;
- kotsi ea methapo ea pelo e eketseha;
- tsoelopele ea mathata a lefu la tsoekere.
Litholoana tsa boemo bo tlase:
- maemo a khafetsa a hypoglycemic;
- anemia ea hemolytic e hlaha, ka lebaka leo lisele tsa mali tse khubelu li felisoang;
- menyetla ea ho tsoa mali e eketseha;
- tšelo ea mali e ka hlokahala;
- mathata a lefu la tsoekere a qala ho tsoela pele ka potlako.
Puo ea video mabapi le matšoao le litlamorao tsa hypoglycemia:
Mabaka a ts'ebetso e fetelletseng le e sa nyenyefatseng
Kamora ho fumana sephetho sa tlhahlobo ea HbA1c e fapaneng le boemo ba sepheo, ho bohlokoa ho tseba sesosa.
Lintho tse bakang keketseho:
- phokolo ea mali
- maemong ana, mmele o haelloa ke tšepe, e lebisang keketseho ea khatello ea HbA1c; - mathata a makhophong;
- ho tlosoa ha lesapo la mokokotlo, ha lisele tse khubelu tsa mali li robeha kahareng ena;
- ho hloleha ha rems;
- tlolo ea metabolism ea lik'habohaedreite, ka lebaka leo tsoekere e maling e nyolohang.
- maemong ana, mmele o haelloa ke tšepe, e lebisang keketseho ea khatello ea HbA1c;Mabaka a ho ba le khatello e tlase ea HbA1c:
- ponahalo ea hlahala ho manyeme (insulinomas), e tlatsetsang ho secretion e ngata ea lihormone le ho hlaha hoa hypoglycemia;
- hypoglycemia e bakoang ke phepo e telele ea carb e tlaase;
- ho hloleha ha adrenal;
- ho ikoetlisa khafetsa le ka nako e telele;
- ho ba teng ha li-pathologies tse sa tloaelehang maemong a liphatsa tsa lefutso (ho se mamellane ha fructose, lefu la Forbes kapa Girke);
- lithethefatsi tse ngata tse reretsoeng ho theola litekanyetso tsa tsoekere;
- anemia ke boemo boo bophelo ba lisele tse khubelu tsa mali bo fokotsehang.
Mabaka a mangata a thathamisitsoeng kaholimo a thusa ho eketseha kapa ho fokotseha ha hemoglobin ea nakoana haeba e sa amane le lefu la tsoekere la mokuli. Letšoao le khutlela boemong bo tloaelehileng ka nako ka boyona kapa kamora hore ho nkuoe mehato e nepahetseng.
Mekhoa ea ho matlafatsa
Bakeng sa kheloho efe kapa efe ho sepheo sa eona, ho bohlokoa ho latela litlhahiso tsohle tsa ngaka e eang teng e le ho e etsa hore e lekane.
Melao ea motheo ea ho tsitsa:
- hlokomela lijo tse hlokoang;
- kena lipapaling;
- u se ke ua lebala ho sebelisa lithethefatsi kapa ho kenya insulin ka mokhoa o sa ts'oaneng ho thibela nts'etsopele ea hyperglycemia;
- latela ka ho hlaka tekanyetso e khothalletsoang ea ngaka ea lithethefatsi e sebelisitsoeng kalafo ea lefu la tsoekere;
- qoba maemo a sithabetsang ka hohle kamoo ho ka khonehang;
- lula a hlokometse glycemia a sebelisa glucometer, le ho fana ka mali makhetlo a 'maloa ka selemo ka laboratoring ho tseba HbA1c;
- ho fokotsa mokokotlo oa hemoglobin ea glycosylated e lokela ho ba butle butle, e le ho qoba boemo ba hypoglycemia bo kotsi 'meleng;
- batho ba nang le lefu la tsoekere ba lokela ho etela endocrinologist khoeli e 'ngoe le e' ngoe ho ea hlahloba matšoao a tsoekere le ho lokisa mofuta oa kalafo haeba ho hlokahala.
Video e tsoang ho Dr. Malysheva mabapi le tlhahlobo ea HbA1c:
Bakuli ba nang le lefu la tsoekere ba lokela ho boloka tlaleho ea letsatsi eo ho eona ba lokelang ho hatisa phetoho litekanyetsong tsa glycemia ka sesupo sa lijo tse jeoang, mofuta oa mosebetsi o entsoeng kapa lintho tse ling tse amang letšoao lena. Sena se tla khetholla kemiso e nepahetseng ea phepo e nepahetseng le ho khetholla lijo tse matlafatsang litekanyetso tsa tsoekere.
