4 Nkwadebe homonụ nke ụjọ
A na-eji ọgwụ Antithyroid eme ihe maka hyperthyroidism (thyrotoxicosis, bazedova ọrịa). Ugbu a, a na-ejikarị ọgwụ antithyroid eme ihe. thiamazole (merkazolil)nke na-egbochi thyroperoxidase ma si otú a na-egbochi iodination nke ahịhịa resrosine nke thyroglobulin ma na-akpaghasị njikọ nke T3 na T4. Inye n'ime. Mgbe ị na-eji ọgwụ a, leukopenia, agranulocytosis, rashes anụ ahụ ga-ekwe omume. I nwere ike ịmụba nke glandị akwara ozi.
Dịka ọgwụ antithyroid, a na-enye iodides n'ime - kalia iodide ma obu sodium ayodiin na oke doses dị elu (160-180 mg). N'okwu a, ayodiin na-ebelata mmepụta nke thyroid na-akpali hormone nke pituitary gland, karị, njikọ na nzuzo nke T na-agbadata.3 na T4 . A na-ahụkwa ụdị usoro nke igbochi ntọhapụ nke homonụ thyroid na-akpali diiodotyrosine. A na-eji ọgwụ eme ọgwụ. Ha na-eme ka mbelata nke olu gland na mọzụlụ. Mmetụta dị n'akụkụ isi ọwụwa: isi ọwụwa, lacrimation, conjunctivitis, mgbu mgbu gland, laryngitis, rashes skin.
Ingba ọgwụ insulin mgbe niile
Insulin dosing: gbachie iche iche.
Optzọ kachasị mma kwesịrị ịbelata glucose ọbara na nkịtị, kpochapụ glucosuria na akara ndị ọzọ nke ọrịa shuga.
Mpaghara Isi Subcutaneous (ọkwa dị iche iche): ihu dị n'ihu mgbidi nwa dị n'okpuru ala, elu mmiri nke ubu, n'ihu elu apata ụkwụ, aka ekpe.
Ọgwụ dị mkpụmkpụ - n’ime afọ (ngwa ngwa iwere),
Ọgwụ ogologo oge - n'úkwù ma ọ bụ aka ekpe.
Ubu adighi adighi nma maka igba onwe gi.
A na-enyocha ike nke ọgwụgwọ site
-echebe usoro nke shuga obara "agu agu" na
- mwepụ nke ya na mmamịrị kwa ụbọchị
Nhọrọ kachasị mma maka ọgwụgwọ nke ụdị shuga 1 bụ
Usoro nke otutu in insulin na-eme ka mmadụ mezie insulin nke anụ ahụ nke insulin.
Na ọnọdụ physiological
basal (ndabere) insulin insulin na-eme ugboro ugboro ma ọ bụrụ na ọ bụ 1 ọgwụ insulin kwa elekere.
N'oge mmega ahụ a na-ebelata insulin na-ejikarị ya.
Ichoro insulin nke ozo (1-2 n’eri n’ime 10 g nke carbohydrates).
Enwere ike ịme ka insulin nzuzo a sie ike dị ka ndị a:
Tupu nri ọ bụla, a na-enye ọgwụ ndị dị mkpụmkpụ.
A na-akwado nzuzo nzuzo nke ọgwụ site na ọgwụ ogologo oge.
Ihe ndi ozo nke igba insulin:
Nsogbu nke Ọrịa Shuga
Inwe insulin na ezughi oke,
Enweghị nlekọta kpụ ọkụ n'ọnụ ozugbo, ọrịa shuga (ya na ụbụrụ ụbụrụ).
egbu egbu oge niile.
- ịba ụba nke CNS na aru ketone,
Ọgwụgwọ mberede rụrụ nsonye mmeghe nke insulin.
N'okpuru mmetụta nke nnukwu insulin n'ime sel yana glucose a gụnyere potassium
(imeju, akwara ọkpụkpụ),
Ọbara potassium ịbara tụlee nke ọma. N'ihi ya, nsogbu obi.
Ihe nfụkasị insulin, ọgwụ insulin na-egbochi.
Lipodystrophy na ntanetị.
Maka ebumnuche mgbochi, a na-atụ aro ịgbanwe saịtị ọgwụ insulin n'ime otu mpaghara.
Nkwadebe homonụ nke Parathyroid
Ugwu hormone parathyroid nke parathyroid na-emetụta metabolism nke calcium na phosphorus. Na-akpata ijupụta ọkpụkpụ anụ ahụ. Ọ na - akwalite nnabata nke ndị nwere kalselia site na eriri afọ, na - ebulite reabsorption nke calcium ma belata reabsorption nke phosphate na tọọles renal. N'akụkụ a, omume nke homonụ parathyroid na-abawanye ọkwa Ca 2+ na plasma ọbara. Lọ ọgwụ parathyroid ọgwụ parathyroidin eji maka hypoparathyroidism, spasmophilia.
1. Nkwadebe insulin na ndị na-arụ ọrụ hypoglycemic synthetic
Insulin na –eme ka ndi n’agba mkpụkọ aru nke aru di aru nma. N'akụkụ a, insulin:
na-akwalite nnabata nke glucose site na mkpụrụ ndụ anụ ahụ (ewezuga usoro nke usoro ụjọ ahụ), na-eme ka ibuga glucose site na membranes cell.
belata gluconeogenesis na imeju,
3) na-akpali guzobe glycogen na itinye ya na imeju,
4) na-akwado njikọ nke protein na abụba ma gbochie catabolism ha,
5) na-ebelata glycogenolysis na akwara na akwara ọkpụkpụ.
Site n’inwe insulin erughi ezughi ezu, oria shuga na-ebilite, nke ike carbohydrate, abụba na protein metabolism na-agbagha.
Idị shuga mellitus (nke na-agbanye insulin) na mbibi nke of-sel nke agwaetiti nke Langerhans. Ihe mgbaàmà nke ụdị ọrịa shuga mellitus: hyperglycemia, glucosuria, polyuria, akpịrị ịkpọ nkụ, polydipsia (oriri na-abawanye ụba), ketonemia, ketonuria, ketacidosis. Sedị ọrịa shuga dị njọ na-enweghị ọgwụgwọ na-egbu egbu, ọnwụ na-eme na ọnọdụ nke hyperglycemic coma (hyperglycemia, acidosis, amaghi, isi nke acetone site na ọnụ, ọdịdị acetone na mmamịrị, wdg). Typedị nke mellitus nke ụdị m, naanị ọgwụ ọgwụ dị irè bụ ịkwadebe insulin nke a na-ahụ parenterally.
Elldị shuga mellitus (nke na-abụghị insulin) na-emetụta Mbelata insulin (mbelata ọrụ β-cell) ma ọ bụ mmepe nke nguzogide anụ ahụ na insulin. Enwere ike jikọta insulin na-ebelata oke ma ọ bụ uche nke ndị na - anabata insulin. N'okwu a, ọkwa insulin nwere ike ịbụ nke nkịtị ma ọ bụdị dị elu. Ọbara insulin dị elu na-enye aka na oke ibu (anabolic homonụ), ọ bụ ya mere ụdị ọrịa shuga II ji akpọ mgbe ụfọdụ oke ibu. Na ụdị ọrịa shuga II nke ọrịa mellitus, a na-eji ọgwụ hypoglycemic a na-ekwu okwu, nke, na-enweghị isi na-ezughị ezu, yana ijikọ insulin.
Ugbu a, usoro insulin kachasị mma bụ nkwadebe insulin na-eme mmadụ. Na mgbakwunye, ha na-a drugsụ ọgwụ insulin nke enwetara site na pancreas pigs (insulin ezì).
A na-enweta nkwadebe insulin nke mmadụ site na inyocha mkpụrụ ndụ ihe nketa.
Insulin na-agwọ mmadụ A na-emepụta (Actrapid NM) na karama nke 5 na 10 ml nwere ọdịnaya nke 40 ma ọ bụ 80 PieCES na 1 ml, yana na cartridges nke 1.5 na 3 ml maka mkpịsị sirinji. A na-enye ọgwụ a n’okpuru anụ ahụ ruo minit 15-20 tupu nri ugboro 1-3 n’ụbọchị. A na-ahọrọ dose ahụ n'otu n'otu dabere ogo hyperglycemia ma ọ bụ glucosuria. Nsonaazụ ahụ na-etolite mgbe nkeji 30 gachara wee rue awa 6-8. Lipodystrophy nwere ike ịmalite ebe ị inụ insulin subcutaneous, ya mere a na-atụ aro ka ịgbanwee ebe injection mgbe niile. Na coma mamịrị, enwere ike inye insulin ọbara ugboro ugboro. Ọ bụrụ na ịulinụ insulin karịrị akarị, hypoglycemia na-amalite. Pallor, ọsụsọ, mmetụta agụụ, ụjọ ịma jijiji, mkpọnwụ ahụ, iwe na-ama jijiji. Hypoglycemic ujo (mwepu nke onwe, nhuju, ihe obi na-arụ ọrụ) nwere ike ịmalite. Na ihe ịrịba ama mbụ nke hypoglycemia, onye ọrịa kwesịrị iri shuga, kuki, ma ọ bụ nri ndị ọzọ glucose. N'ọnọdụ akpọnwụ hypoglycemic, glucagon ma ọ bụ 40% glucose na-agunye intramuscularly.
Nkwụsị nke Zinc kwụsịtụrụ insulin nke mmadụ A na-edozi Ultratard HM naanị n'okpuru anụahụ. A na - enweta insulin nwayọ nwayọ site na anụ ahụ dị n'okpuru ala, mmetụta ahụ na - etolite mgbe awa anọ gachara, nsonaazụ kachasị mgbe awa 8-12 gachara, ogologo oge a ga - eme ya bụ awa 24. A ga - eji ọgwụ ahụ dị ka onye nnọchianya na - ejikọta ya na ọgwụ ngwa ngwa.
Nkwadebe insulin na-efe efe na -eme ya na nkwadebe insulin mmadụ. Agbanyeghị, mmeghachi omume nfụkasị ahụ ga-ekwe omume na iji ha.
Insulinsolubleịnọpụ iche emepụtara na karama dị milimita iri nke ihe dị n'ime afọ 40 ma ọ bụ iri asaa n'ime 1 ml. Tinye n'okpuru anụ ahụ minit 15 tupu nri ugboro 1-3 n'ụbọchị. Nlekọta intramuscular na intraven ga-ekwe omume.
Insulin-zincnkwusioruamorphous nke a na-ahụ naanị n'okpuru anụ ahụ, na-enye nnabata insulin site na ntụtụ ahụ, ma, yabụ, imekwu ogologo. Mbido nke ihe dị ka awa 1.5 gasịrị, ọnụ ọgụgụ kachasị elu nke ihe dị ka awa 5-10 gasịrị, oge ọrụ ga-abụ awa 12-16.
Ntinye insulin Zinc Crystal nke emere n'okpuru anụahụ. Mbido nke ime ihe dị ka awa 3-4 gachara, oge kachasị rue mgbe elekere iri nke iri nke 30-30, oge nke ihe a bụ awa 28-36.
Mkpụrụ nnọkọ hypoglycemic na-eme ihe
A na - ahụ iche otu ndị a na - ahụ maka ihe eji eme ihe hypoglycemic.
1) sulferilurea dị iche iche,
Nri nke sulfonylureas - butamide, chlorpropamide, glibenclamide nke enyere n’ime. Ọgwụ ndị a na - akpali sel insulin nke sel nke agwaetiti nke Langerhans.
Usoro nke usoro sulfonylurea sitere na mgbochi nke ọwa mmiri ATP nke dabere na mkpụrụ ndụ and-sel na depolarization nke mkpụrụ ndụ. N'okwu a, ọ nwere ikike ịgbatị ọwa Ca 2 + na-arụ ọrụ, ntinye Ca g + na-akpali mmụba insulin. Na mgbakwunye, ọgwụ ndị a na-eme ka ọgụgụ isi nke ndị na - anabata insulin na - eme ihe nke insulin. E gosiputara na ihe ndị na-enye ume na ume dị elu na insulin na-ebute glucose na sel nke abụba. A na-eji usoro Sulfonylurea eme ihe maka ụdị ọrịa shuga II nke ọrịa mellitus. Dị ọrịa shuga m na-arịa, ha anaghị arụ ọrụ. Anọrọ na ngwa ngwa. Ọtụtụ na-ejikọ protein protein. Metabolized na imeju. A na-egbochi metabolabolites tumadi site na akụrụ ya, akụkụ ya nwere ike ịmịchasị yana bile.
Mmetụta ndị ọ na-enwe: ọgbụgbọ, uto ọla n’ọnụ, ihe mgbu n’afọ, leukopenia, mmeghachi ahụ nfụkasị. Annweta usoro ọgwụ ndị a na-enweta n’ọgwụ sulfonylurea, hypoglycemia ga-ekwe omume. A na-egbochi ọgwụ ọgwụ maka ọrịa imeju, akụrụ, na ọbara.
Biguanides - metformin họpụtara n'ime. Usoro:
1) na-abawanye uru glucose site na uru anụ ahụ, karịchaa akwara,
2) belata gluconeogenesis na imeju,
3) na-ebelata nnabata nke glucose na eriri afọ.
Na mgbakwunye, metformin na-ebelata agụụ, na-akpali lipolysis ma na-egbochi lipogenesis, na-ebute mbelata ahụ. Edere ya maka ụdị ọrịa shuga II nke ọrịa mellitus. Ọgwụ ahụ agbasachaala nke ọma, oge ihe ọ dị bụ ruo awa 14. Mmetụta dị iche iche: lactic acidosis (ịba ụba lactic acid na plasma ọbara), mgbu na obi na akwara, mkpụmkpụ ume, yana ụtọ otite n'ọnụ, ọgbụgbọ, vomiting, afọ ọsịsa.
2.3.1.2. Homonụ nke anụ ahụ na mkpụrụ ndị na - agbanwe agbanwe ha
Na-eme ka pancreas kpuchie homonụ abụọ: insulin na glucagon, nke nwere mmetụta dị iche iche n'ọkwa glucose dị n'ọbara. Insulin na-ebelata glucose ọbara, na-ahụ na ọ na-ebugharị site na membranes cell na ojiji na anụ ahụ, na-akpali nguzobe nke glucose-6-phosphate, na-eme ka usoro nke mmepụta ike, na-akpali njikọ nke protein na abụba abụba. Ọ bụ ọrịa shuga mellitus na - akpata ọrịa insulin - ọrịa siri ike, nke gosipụtara site na mmụba shuga n'ọbara ya na mmamịrị ya, usoro oxidative na - akpata ya (yana uru ahụ ketone), ọria metabolism na mmepe nke vaskụla ọrịa obi (ọrịa ụkwara ume ọkụ angiopathies). Mkpụrụ ndụ Carbohydrate na-egbu mkpụrụ ndụ (anụ ahụ na - eme ka insulin na - ahaghị n ’ọhụụ), elektrolyte na enweghi ketoacidosis na - ebute mmepe nke ngosipụta siri ike nke ọrịa mellitus - ọrịa shuga.
Insulin bu protein nke nwere otutu polypeptide nke ejikọtara n'okporo mmiri bu otutu. Ka ọ dị ugbu a, ejirila insulin nke ụmụ mmadụ na ụmụ anụmanụ mee, usoro biotechnological rụpụtara maka mmepụta ya (insulin engineering genet). A na - eji insulin eme ihe maka insulin na - arịa ọrịa shuga mellitus na ebumnuche nke ketoacidosis. Mmeghe nke insulin na ndị ọrịa nwere ọrịa shuga na-eduga na mbelata shuga ọbara na nchịkọta nke glycogen na anụ ahụ. Mbelata glucosuria na polyuria na polydipsia na-esite na ya. A na-ahụkarị usoro protein na lipid, nke na-ebute mbelata ihe ndị dị na ntọala nitrogenous na mmamịrị. A ga - achọta ozu Ketone n'ọbara na mmamịrị.
N'ime omume ahụike, a na-eji nkwadebe insulin nwere dura dị iche iche nke ime ihe (mkpụmkpụ, ọkara, ogologo). A na-agbakọ ọ̀gù n’otu n’otu, na-eburu n’uche usoro ahụ. Iji belata ọnụ ọgụgụ ndị inje, mgbe ha nwetasịrị ụgwọ, a na-enyefe ndị ọrịa na insulin na-arụ ọrụ ogologo oge: nkwụsị nke ọgwụ zinc-insulin, nkwusioru nke insulin-ultralong, protamine-zinc - insulin. Ọtụtụ mgbe, a na-ejikọkọta ngwakọta nke dị iche iche (na usoro nke oge ọrụ) maka insulin. Nkwadebe insulin enweghị ihe ndọghachi azụ. Insulinase na-arụ ọrụ n'ime imeju site na insulinase, nke a na-eduga na oge ezughi oke nke ihe ọ na-eme (awa 4-6). Inje insulin na-egbu mgbu nke ukwuu; infiltrates nwere ike ime na ebe injection. Insulin na ụdị ya dị ogologo nwere ike ibute mmeghachi omume nfụkasị. N'ihi ị anụ ọgwụ insulin karịrị akarị, a ga-enwe ike ibu hypoglycemic. Site na obere hypoglycemia, enwere ike ịkwụghachi ya ụgwọ site na ị sugarụ shuga ma ọ bụ nri nwere carbohydrates, yana coma ọ dị mkpa iji nchịkwa glucose parenterally.
Na mgbakwunye na insulin, a na-eji mmiri ọgwụ hypoglycemic synthetic mee ihe dị ka ndị nnọchianya hypoglycemic. Ihe ndi a gunyere sulfonylurea ihe ndi ozo: tolbutamide (butamide), chlorpropamide, biguanides: buformin (glibutide, metformin (glucophage, glyformin)) Edebere sulfonylureas maka oria shuga na mgbakwunye na usoro nri nri. ya na insulin na sulfonamides.Ihe achoro ka eme ihe banyere ihe ndi na - egbu egbu bu ihe omuma n’inwe insulin insulin na mmata nke cell n’ime ya. sheney. usoro nke ihe nke biguanide nkwekọrịta uru mere site mmetuta nke glucose uptake na suppression nke glucose absorption Filiks.
