Mkpebi nke gemocosylated haemoglobin n'ime ọbara: ihe dị mkpa nke ụzọ ndị ahụ

Clinical mkpa nke mkpebi siri ike na haemoglobin
Haemoglobin glycated, ma ọ bụ glycogemoglobin (egosipụtara n'ụzọ dị mkpirikpi: haemoglobin A1c, Hba1c) Ihe ngosi ọbara ọbara nke ndu sitere na ndu nke gosipụtara nkezi ọbara ọbara ogologo oge (ruo ọnwa atọ), na iche na ịtụle glukos ọbara, nke na-enye echiche banyere ogo glucose ọbara naanị n'oge ọmụmụ.
Ihe haemoglobin glycated na-egosipụta pasent nke ọbara haemoglobin na-enweghị njikọ ọ bụla n'ime sel glucose. A na-eme ka haemoglobin glycated rụpụtara n'ihi mmeghachi omume Maillard dị n'etiti ọbara ọgbụgba na ọbara. Mmụba na glucose ọbara na-arịa ọrịa shuga na-eme ka mmeghachi omume a dịkwuo nkọ, na-eduga n'ịbawanye n'ọkwa haemoglobin glycated n'ime ọbara. Ndụ ndụ ọbara ọbara (sel ọbara ọbara), nke nwere haemoglobin, ihe dị ka ụbọchị 120-125. Ọ bụ ya mere ọkwa glucose glycated gosipụtara nkezi glycemia dị ka ọnwa atọ.
Glycated haemoglobin bụ ihe na - egosi glycemia nke ọnwa atọ. Di elu ogo nke gemoclobin glycated, ka glycemia dị elu karịa ọnwa atọ gara aga, n'ihi ya kwa, ọ nwere nnukwu ọghọm nke ibute ọrịa shuga.
A na-ejikarị nyocha nke hemoglobin glyc chọpụta banyere ọgwụgwọ ọrịa ọnwa atọ gara aga. Site n'ọbara haemoglobin glycated dị ukwuu, mgbazi nke ọgwụgwọ (ọgwụ insulin ma ọ bụ mbadamba shuga dị ala) yana usoro nri.
Valueskpụrụ nkịtị bụ HbA1c sitere na 4% ruo 5.9%. Na ọrịa shuga, ọkwa nke HbA1c na-ebili, nke na-egosi ohere dị ukwuu nke ịmalite ọrịa retinopathy, nephropathy na nsogbu ndị ọzọ. Ditù Mba Ọrịa Shuga na-atụ aro idobe ọkwa HbA1c n'okpuru 6.5%. Otu uru nke HbA1c karịrị 8% pụtara na ọrịa shuga adịghị achịkwa nke ekwesịrị ịgbanwe.

Nkwadebe omumu ihe

Glycosylated ma ọ bụ glycated haemoglobin (HbA1c) bụ ihe ngosipụta nke gosipụtara ọkwa glucose n’ime ọbara n’ime ọnwa 1-2-3 gara aga. Isi ihe ngosi maka ojiji: nyochaa usoro ọrịa shuga (oge 1 n’ime ọnwa atọ), na-elele ịdị irè nke ọgwụgwọ nke ọrịa shuga, ihe ngosi nke ihe ize ndụ nke nsogbu shuga.
Glycosylated ma ọ bụ glycated haemoglobin (HbA1c) bụ ngwakọta nke haemoglobin A na glucose, bụ́ nke a na-eme n’arụghị enzyme. Ihe dị ka 5-8% nke haemoglobin na mkpụrụ ndụ ọbara uhie na-ejikọ ọnụ n'ụzọ glucose. Usoro glucose na moraglobin haemoglobin bụ usoro nkịtị, mana n'oge ndụ nke ọbara ọbara na-abawanye ụba ogologo oge glucose dị n'ọbara, pasent a na-abawanye. A na-akpọ ụmụ irighiri mmiri haemoglobin ndị a glycosylated. Enwere otutu hemoglobins glycosylated (HbAIa, HbAIb, HbAIc). Ekwenyere na haemoglobin - HbA1c (n'ihi ọnụọgụ ya buru ibu) nwere akacha ahụike. Ọbara nke glycosylated haemoglobin na-adabere na njupụta nke glucose na ọbara. Nyere na erythrocyte nwere nkezi afọ ndụ nke ụbọchị 120, mkpebi siri ike nke ọdịnaya HbA1c ga-egosipụta nkezi glucose ọkara n'ime ọnwa 1-2-3 tupu ọmụmụ ihe ahụ.
Na mgbakwunye na haemoglobin, usoro ndị a dị n'okpuru glycation: albumin, collagen, protein lens protein, transinrin, protein embthrocyte membrane na ọtụtụ protein na enzymes ndị ọzọ, nke na-eduga n'ọgba aghara nke ọrụ ha na nhụsianya nke ọrịa mellitus.
Healthtù Ahụ Ike Worldwa na-ahụ mkpebi siri ike nke glycosylated hemoglobin dị ka ihe dị mkpa maka nyochaa usoro oria shuga otu ugboro kwa ọnwa atọ.
Mkpebi nke HbA1c na-enye gị ohere nyochaa ọdịnaya glucose n'etiti nleta dọkịta. Dị elu karịa n'ọbara HbA1c nke onye ọrịa, ọ ka njọ ịchịkwa glucose ịta ahụ.
Normalization nke larịị nke HbA1c n'ọbara na-apụta na izu isii mgbe emesịrị ọkwa glucose nkịtị. Mgbe ị na-eleba anya na ịgwọ ọrịa shuga, a na-atụ aro ka ọ nwee ike ịba ọcha n'anya glycated hemoglobin n'okpuru 7% ma tụlee ọgwụgwọ ahụ ma ọ bụrụ na ọ karịrị 8% (dị ka usoro maka ikpebi HbA1c na ụkpụrụ nkịtị n'ime 4-6%).
A na-eji glucose glucose eme ihe dị ka ihe na-egosi ihe ize ndụ nke ibute ọrịa shuga.
Valueskpụrụ ndị ahụ nwere ike ịdị iche n'etiti laboratories dabere na usoro nyocha eji, yabụ ị na-enyocha nlezianya n'ime ọnọdụ arụmọrụ kachasị ma ọ bụ opekata mpe site na otu usoro.
Enwere ike ịgbanwe ihe nrịbama nyocha n'ọnọdụ ọ bụla na-emetụta nkezi afọ ndụ nke sel ọbara. Ọbara ma ọ bụ hemolysis na-akpata mbelata ụgha na nsonaazụ HbA1c. Mmịnye ọbara na-agbagọ nsonazụ ya. Site na anaemia ụkọ iron, a na-achọpụta mmụba ụgha na HbA1c.

Nkwadebe nyocha

• Ekwesịrị ịkọwa ya onye ọrịa ahụ na ọmụmụ ihe ahụ ga-enyocha ịdị mma nke ọgwụgwọ antidiabetic.
• Ekwesiri ịdọ aka ná ntị na maka ọmụmụ ihe ahụ, ọ dị mkpa ị takeụ nyocha ọbara ma gwa onye ga-anara ọbara site na akwara.

• Mgbe ntụpọ gasịrị, veins na-achịkọta ọbara n'ime tub na EDTA.
• Ejiri bọọdụ owu na-apịa ebe a na-adọtị ya ọgụ ruo mgbe ọbara ọgbụgba ahụ kwụsịrị.
• Site na nguzobe nke hematoma na ebe ozuzu oke, a na-enye ndenye ihe mkpuchi ọkụ.
• Edere onye ọrịa ahụ ka o nyochaghachi ya ka izu asatọ gachara.

• Dị ka ọ na-adịkarị, ọdịnaya nke haemoglobin glycosylated bụ 4.0 - 5.2% nke ngụkọta haemoglobin.

Ihe na-emetụta nsonaazụ ọmụmụ a

• Ihe na-agbanwe agbanwe

Nnyocha ọbara na-ezighi ezi - ijikọ ọbara nke ezughi oke na in vitoagulant in vitro anticoagulant (EDTA).

• Ihe Ndị Na-eme Ka Nsonaazụ Rụọ
  • Carbamylated haemoglobin (amụrụ n'ime ndị ọrịa nwere uremia).
  • Hydrochlorothiazide.
  • Indapamide.
  • Morphine.
  • Propranolol.
  • Hangha ndị adịgboroja

Hemoglobin F (nwa ebu n’afọ) na etiti labile nwere ike bute nsonaazụ ụgha na nsonaazụ.
Haemoglobin glycated. Nyocha maka hemoglobin nke glycosylated. Mee nyocha iji mee ka ọbara shuga dịkwuo elu
Isiokwu Nnyocha nyocha
Hemoglobin Glycated (HbA1c)

Edeghi ọnụahịa (ọnụahịa nyocha) nwa oge na weebụsaịtị anyị.
Na njikọ maka mmelite ụdị eletrọniki nke saịtị ahụ.

Ọbara glucose na protein (gụnyere haemoglobin) yana ịmebe ntọala Schiff. Ya mere, mmụba ọ bụla na-adị mkpụmkpụ nwa oge na glucose n'ọbara na-ahapụ akara pụrụ iche n'ụdị haemoglobin nwere afọ ojuju. HbA1 mejuputara uzo ato bu HbA1a, HbA1b, HbA1c. N'ụzọ dị mkpa, HbA1c na-emeri.

Ọkwa HbA1c na-egosipụta hyperglycemia nke mere n'oge ndụ ọbara ọbara ndụ ndụ (rue ụbọchị 120). Mkpụrụ ndụ ọbara ọbara na - agbanye n'ime ọbara nwere afọ dị iche iche, yabụ, maka ogo ogo ogo glucose na - eduzi ndụ ọkara nke mkpụrụ ndụ ọbara - ụbọchị iri isii. Ya mere, ọkwa nke haemoglobin glycins na-egosi ihe ndọpụ glucose dị n'izu anọ gara aga nke asatọ ma nke a bụ ihe na-egosi nkwụghachi nke metabolism metabolism n'oge a. Mmese nke ịta HbA1 na-enye ohere nyochaghachi ogo ogo hyperglycemia na ọrịa shuga mellitus. Mmetụta nke glycosylation adịghị adabere na ụda kwa ụbọchị nke mgbanwe na ọkwa glucose n'ọbara, na ọrụ anụ ahụ, ọdịdị nri, mmega ahụ ma dabere na ịdị ukwuu na oge hyperglycemia. N'ime ndị ọrịa nwere ọrịa mellitus nwere hyperglycemia na-adịgide adịgide, ntinye nke HbA1c na-abawanye nke ukwuu. A na-agwọ ọrịa shuga site na ọgwụ ndị na-eme ka glucose ọbara dị ala naanị oge dị mkpirikpi, ya mere ọ dị ezigbo mkpa ịhọrọ ụdị ọgwụgwọ a ga-eme ka usoro glycemia sie ike. Uru nke nyocha nke glycosylated haemoglobin na ọrịa shuga bụ HbA1c mara ọkwa ụfọdụ glucose n'ọbara ogologo oge, nke a pụrụ iji ya tụnyere ọkara ndụ nke ịba ọcha ahụ. Nke ahụ bụ, glycosylated haemoglobin mara ogo nke akwụ ụgwọ ọrịa shuga n’ime ọnwa 1-2 gara aga. A na-akwụghachi ọrịa shuga dị mma ụgwọ, obere ihe ize ndụ nke ịmalite nsogbu ọrịa shuga dịka mmerụ anya - retinopathy, mmebi akụrụ - nephropathy, mmebi nke akwara ndị dị n'akụkụ yana arịa ọbara na-eduga na gangrene. Yabụ, ebumnuche dị n’etiti ịgwọ ọrịa shuga bụ iji hụ na edobere glucose na ọkwa ọ bụla. Mmesho shuga dị n'ọbara dị mma na-enye gị ohere inyocha ọkwa glucose na-adịru nwa oge, mkpebi siri ike nke HbA1c na-enye echiche ejikọtara ọnụ maka ogo nke glycemia.

Ormlọ arụ: 3.5-7.0 μM fructose / g hamoglobin ma ọ bụ 3.9 - 6.2%

Mkpebi nke HbA1c dị ezigbo mkpa n’ime ụmụ nwanyị nwere ọrịa shuga mgbe ha na-eme atụmatụ ịtụrụ ime na n’oge ime. E guzobere ya na ọkwa HbA1c nke dị ọnwa isii tupu ịtụrụ ime yana oge izizi nke afọ ime dabara na nsonaazụ ya. Nchịkwa siri ike na ọkwa nke glycemia na-ebelata mbibi mmebi nke nwa ebu n'afọ na 33% ruo 2%.

Forzọ maka mkpebi siri ike nke haemoglobin nke glycosylated

Glycosylated haemoglobin - njikọ dị n'etiti sel ọbara ọbara na carbohydrate. Ọ na-aghọ onye a na-apụghị ibibi ebibi. Ya mere, Dọkịta nwere ike ịchọpụta ihe na-egosi n’ime ọbara n’ime ndụ mkpụrụ ndụ ọbara uhie (ọnwa atọ). Na nkọwa zuru ezu banyere ihe haemoglobin glycosylated dị.

Iji mata ọdịnaya nke ihe ngosi ahụ, ha na-enye ọbara maka nyocha. Mmiri mmiri na - achọsi ike nke mmiri ma ọ bụ nke na - adọrọ adọrọ dị mma maka nke a.

Mgbe iwere ihe omimi ahụ, a na-etinye ihe na ọkpọkọ ure na-egbochi ọbara inye ọbara. Ọ bụrụ n'ụkpụrụ uwe, nyocha ọzọ agaghị adị. A na-agwakọta ihe dị n'ime akpa ndị ahụ, ọ bụ naanị tinye ya n'ime onye nyocha. Ọ na - agbakọ akara na-akpaghị aka, ma na-enye data na akwụkwọ ọmụmụ.

Ojiji nke ngwaọrụ na-ewepụ ohere nke ọgwụ njehie na ịgbakọ ọnụọgụ nke ihe ndị dị mkpa. Nke ahụ bụ, data dị otú ahụ ga-abụ ihe kacha ntụkwasị obi. Mana iji gosipụta ọnụọgụ nke ihe ngosi ahụ, a na-atụ aro ka o duzie ọmụmụ ihe ugboro abụọ. Mgbe nnata nke otu ihe ngosi ahụ, a na-ele ule ahụ anya.

Glycosylated Hemoglobin Analyzer

Eweputala otutu udiri ihe eji eme ihe, nke i nwere ike ichoputa ihe ngosi di iche banyere ndu mmadu. Enwere ọtụtụ ngwaọrụ maka ịchọpụta haemoglobin glycosylated.

• Chromatograph Liquid. E kee ọbara n'ọtụtụ ụzọ nke nyochara ihe ngosipụtara.
• Ion mgbanwe chromatograph. Na-ekewa ion na molekul. Mgbe agbakwunyela ọtụtụ ihe ndozi, o kwere omume tụta ụfọdụ irighiri ihe. Ihe atụ nke ụdị ihe eji arụ ọrụ a bụ ihe nyocha maka ịchọpụta glycosylated haemoglobin D10.
• Immunoturbidmetry. Na-ekpebi ihe ngosipụta site na ịhazi nha nke ọbara na njikọta nke ihe mgbochi antigen-antibody.
• Obere nyocha. Họrọ onye ọrịa ọ bụla maka iji ya rụọ ụlọ. Iji mee nyocha, achọrọ obere ego eji edozi ahụ, bụ nke a na-enweta site na iji akpụkpọ anụ ịchafụ anụ ahụ. Ngwaọrụ ahụ sitere na photometry, tụọ nha nfe. Onye ọ bụla n'ime ha nwere fluorescence (luminescence), nke na-ekpebi nsonaazụ nke ihe ngosi ahụ. Gụọ nyocha zuru ezu nke ndị nyocha ọbara ọbara ụlọ.

Ọ bụrụ na onye ọrịa nwere nsogbu ahụike, shuga dị n'ọbara ya kwa oge, dọkịta na-atụ aro ịzụta onye nyocha ụlọ. Glycosylated hemoglobin reagent ngwaọrụ kwesịrị ịdị mfe iji ka ndị ọrịa niile wee nwee ike iji ha.

Ihe ntinye maka mkpebi siri ike nke haemoglobin glycosylated

Ihe kit nwere ihe ndị a chọrọ chromatography:

• Ndị na-egbochi mkpuchi, dịka ọmụmaatụ, EDTA,
• haemolytic elekọta mmadụ na-ebibi glucose ọbara ọbara
• ihe ndozi - mmiri nke na-ejigide steeti acid-base nke ihe ngwọta,
• acetic acid ngwọta - mmiri mmiri dị mkpa iji wepu ngafe mmiri na ule ihe,
• nlele njikwa - dị mkpa iji tụọ nsonaazụ ya na usoro,
• Ngwaọrụ eji emeghari akpaka, nke bu ihe nyocha.

Ihe ndị a dị n’elu nwere ike ịbụ nke ụlọ ọrụ dị iche iche, mana ebumnuche maka ha ka bụ otu ihe. Mkpebi nke ọ bụla n'ime haemoglobin glycosylated dị n'ọbara gụnyere ntuziaka maka ojiji.

Mkpebi nke haemoglobin glycosylated n'ime ọbara niile

Dọkịta kwesịrị ịgwa onye ọrịa ahụ otu esi eme nnwale maka ịchọpụta gemocolobin glycosylated n'ọbara niile.

Maka ule ahụ, a na-etinye ihe na tube nyocha nke na-egbochi ịmịnye ọbara. A na-agbakwunye ọbara dum na ya. Oke kwesịrị ịbụ otu. Ngwakọta a na-esi na ya agwakọta juputara na esi ọnwụ. Ya mere, a na --ezoba uka erythrocyte, nke aghaghi iji pipette were were were bute ya na ulo nnwale ebe obara ya di. A na-agwakọta mmiri mmiri a na-esi na ya apụta. N’oge a, a na-amalite usoro haemolysis, ya bụ, mkpụrụ ndụ ọbara ọbara na-emebi, naanị glucose na-adịgide. Ngwaọrụ kpebisiri ike.

Mkpebi nke glycosylated haemoglobin n'ọbara ọbara

Ọbara bụ anụ ọbara mmadụ nke esite na ọbara dum. Maka nke a, etinye etinye ihe nlele ahụ n'ime ọkpọ ule ma debe ya na centrifuge. Ọ na-arụ ọrụ na oke ọsọ. Mgbe minit 10 gachara, a na-akwụsị ngwa ahụ. Mmiri mmiri na-acha odo odo na-adị n’elu tube ahụ, nke bụ ọbara. A na edobere ihe ndozi n’otu, yabụ na akụkụ a ga - enwe ncha uhie.

Nnwale ahụ na-aga n'ihu n'ọtụtụ nkebi:

• ọbara, haemoglobin ngwọta, mmiri dị ọcha na-agbakwunye na tube
• kewapụ iche nke njikwa mejupụtara ọbara na mmiri distilled,
• ma arịa abụọ ahụ siri ọnwụ, tinyezie ya na nnukwu ọsọ ọsọ,
• n’elu eriri ahụ, a na-ewepu odo odo nke mmiri mmiri ahụ wee belata ammonium sulfate.

Nsonaazụ bụ mmiri si n'ọbara ọbara, nke enwere ike nyocha ya na photoelectrocolorimeter. Nke a bụ ngwaọrụ na-ekpebi efegharị efegharị. A na-etinye data sitere na ya n'ime usoro maka ịchọpụta mkpochapụ. Ọ dị mkpa iji chọpụta ihe oriri kwa 1 lita ọbara.

Mkpebi hemoglobin nke glycosylated na-arịa ọrịa shuga

A na-egosipụta akara ngosi nke naanị n'ime oge dị ka ọnwa atọ. Yabụ, a na-eme ọmụmụ ahụ otu otu. O kwere omume iji nyocha nyocha mgbe ụbọchị ole na ole gachara iji gosi nsonaazụ ahụ. Mana agbanyeghị nke a, data enwetara metụtara ihe ndị a pụrụ ịdabere na ya. Dabere na ha, dọkịta nwere ike ikpe usoro ndị a:

• ịdị mma nke ọgwụgwọ ọgwụ, nke a na-agbazi mgbe ị na-enweta data ọjọọ,
• mebiri site na onye ọrịa nke ụkpụrụ omume maka hyperglycemia, nke gụnyere ị ofụ carbohydrates, arụ ọrụ anụ ahụ, akwara ụjọ.

Dị Mkpa! Site n'ọbara hyperglycemia, a na-atụ aro ka tụọ ọkwa glucose kwa oge site na iji mita glucose ọbara n'ụlọ. Nnwale ahụ glycosylated bụ ihe ọmụma naanị otu ugboro n’ime ụbọchị 120 ọ bụla.

Ọrịa shuga mellitus bụ ọrịa dị ize ndụ nke juputara na nsogbu na-ebelata oke obibi onye ọrịa, ma ọ bụ bute ọnwụ ya. A na-atụ aro ka ị medicationụọ ọgwụ n’oge, na-agbaso nri. Eterchọpụta haemoglobin glycosylated na-enye dọkịta ohere inyocha ogo ọgwụgwọ, ịgbanwe ya.

Glycosylated haemoglobin - gịnị ka ọ bụ?

Ka anyị leba anya n'ụzọ zuru ezu ihe ọhụụ dị n'ọbara ga-apụta. Mkpụrụ ndụ ọbara ọbara nwere protein dị n’ime ya nke iron, nke dị mkpa maka ibugharị oxygen na carbon dioxide. Ọ bụ glucose (shuga, carbohydrates) nwere ike ijikọ ya na enzymatically, na-akpụ glycosylated haemoglobin (HbA1C). A na-eme ka usoro a dịkwuo elu site n'ịba ụba shuga (hyperglycemia). Nkezi afọ ndụ mkpụrụ ndụ ọbara uhie dị n’ihe dị ka ụbọchị 95 - 120, yabụ ọkwa HbA1C na-egosipụta njikọta nke glucose n’ime ọnwa atọ gara aga. Usoro nke gemocosylated haemoglobin dị n'ọbara bụ 4-6% nke ngụkọta oge yana dakọtara na shuga nkịtị nke 3-5 mmol / l. Ihe kpatara mmụba a bụ njikọta na imebi metabolism na glucose dị n'ọbara ogologo oge.

• Ọrịa shuga mellitus ụdị 1 (insulin-dependence) - na insulin (homonụ nke pancreatic), ịba uru nke carbohydrates site na mkpụrụ ndụ nke anụ ahụ na - akpaghasị, nke na - eduga n'ịba ụba ogologo oge na ntinye.
• Elldị shuga abụọ nke ọrịa mellitus (nke na-abụghị insulin) - na - ejikọta ya na iji glucose ike arụ ọrụ n'oge mmepụta insulin nkịtị.
• Usoro ọgwụgwọ na-ezighi ezi nke ọkwa carbohydrate dị elu na-eduga na ịba ụba hyperglycemia ogologo oge.

Ihe na-akpata ọbara mgbali elu glycosylated, nke na-abụghị ihe metụtara glucose n'ọbara:

• egbu egbu egbu
• bute nnu nnu,
• ụkọ iron
• mwepu nkpuru ogwu - arua bu aru nke eji ewepu sel ọbara n’agha (ya bu “alaili” nke sel ọbara), ya mere na odighi ya n’eduba na ndu ha n’enwe ogologo oge na mgbakwunye na HbA1C,
• uremia - ezughi oke nke akụrụngwa na-eme ka nchịkọta nke ngwaahịa metabolic n’ime ọbara na nguzobe nke carhemoglobin, nke bụ otu ihe ahụ na glycosylated.

Ihe kpatara HbA1C mbelata

Mbelata nke ọbara ọgbụgba na glycosylated bụ akara ọgbụgba, na-eme n'ụdị ndị a:

• Ọnwụ ọbara dị ukwuu - yana haemoglobin nkịtị, glycosylated na-efu.
• Mmịnye ọbara (ịmịnye ọbara) - HbA1C na-agwakọta ya na irighiri ihe okike ya, nke ejikọtaghị ya na carbohydrates.
• Hemolytic anaemia (anaemia) bụ otu ọrịa nke ọrịa hematological nke na-ebelata oge ịdị adị nke mkpụrụ ndụ ọbara uhie, yana sel nwere glycosylated HbA1C na-anwụkwa na mbụ.
• Ogologo hypoglycemia - mbelata glucose.

Ekwesịrị icheta na ụdị mmebi nke haemoglobin nwere ike ịgbagọ nsonaazụ nyocha ahụ ma nye mmụba ụgha ma ọ bụ ibelata n'ụdị ya glycosylated.

Uru atụnyere atụnyere nchịkọta mgbakọ shuga

• Nri - na - eme ka mmụba dị elu na ịba ụba carbohydrate, nke na - alaghachi na nkịtị n'ime awa ole na ole.
• Ihe mmetụta uche, nrụgide, na mgbede ule, na-eme ka glucose dị n'ọbara n'ihi mmepụta nke homonụ na-abawanye ọkwa ya.
• Drugsakingụ ọgwụ shuga dị ala, imega ahụ na-ebelata glucose.

Ya mere, nnwale nke oge shuga maka ọkwa shuga nwere ike igosi mmụba ya, nke na-egosighi mgbe niile ọnụnọ nke imebi metabolism ya. Na, ọzọ, ọdịnaya nkịtị apụtaghị na enweghị nsogbu na metabolism nke carbohydrates. Ihe ndị a dị n'elu anaghị emetụta ọkwa nke gemocololated nwere nkwarụ na-adịghị mma. Ọ bụ ya mere nkọwa ya ji bụrụ ihe ngosipụta ebumnuche na nchọpụta mbụ banyere ọrịa metabolism na-emetụta ahụ. Ihe ngosi maka omumu: N'ozuzu, a na-eduzi ọmụmụ ihe ahụ iji chọpụta nke ọma na metabolic ọrịa nke carbohydrates ma rụọ ọrụ n'ọnọdụ ndị a:

• 1dị nke atọ nke ọrịa shuga mellitus, yana oke juputara na carbohydrate na obere oge.
• Nchoputa mbu banyere oria abuo.
• Metabolism na-arụ ọrụ nke ukwuu n'ime ụmụaka.
• Ọrịa mamịrị nwere mbata na-enweghị aha dịkarịsịrị ala, mgbe akụrụ kpụrụ akụkụ dị ukwuu nke carbohydrates.
• N’ime ụmụ nwanyị ndị tụtara ime ma nwee ọrịa shuga, ụdị 1 ma ọ bụ abụọ tupu.
• Ọrịa shuga - mmụba shuga dị n’ọbara n’oge ịtụrụ ime, n’ihe banyere ọrịa shuga adịtụbeghị mbụ. Nyocha shuga na nke a nwere ike igosi mbelata, ebe ọ bụ na oke akụkụ nri nri na ọbara na-abanye na nwa ebu n’afọ na-eto.
• Njikwa ọgwụgwọ - uru nke glycosylated haemoglobin ọdịnaya na-egosi nnabata shuga ruo ogologo oge, nke na-enye anyị ohere ikpe ikpe ịdị mma nke ọgwụgwọ, nke enwere ike idozi ndị ọrịa mamịrị dịka nsonaazụ nyocha.

Kedu ihe kpatara o ji dị mkpa ịchọpụta ọghọm nke metabolism metabolism n’ahụ dị ka o kwere omume? Mmụba dị elu n'ogo shuga na-eduga na nsonaazụ a na-aghazighi ahụ n'ime ahụ n'ihi njikọ aka ya na protein, bụ:

1. HbA1C nwere ntụpọ anaghị arụ ọrụ nke ụgbọ njem oxygen zuru oke, nke na-ebute hypoxia nke anụ ahụ na akụkụ ahụ. Na ngosipụta dị elu a, ogo oxygen dị ala na anụ ahụ.
2. Mmetụta anya (retinopathy) - njikọkọta glucose na protein nke retina na anya anya.
3. Ọdịda akwara (nephropathy) - itinye ụrọ nke carbohydrates na tubules nke akụrụ.
4. Pathology nke obi (cardiopathy) na akwara ọbara.
5. Ihe na - emetụta ọgịga akwara (polyneuropathy).

Etu esi ewere nyocha?

Maka nyocha, a na-ewere ọbara n'oche dị n'ọdịdị 2-5 ml yana agwakọta anticoagulant iji gbochie mpịachi ya. Nke a na-eme ka o kwe omume ịchekwa ihe dị ka izu 1, okpomọkụ +2 + 5 Celsius С. Ndụmọdụ ọ bụla pụrụ iche tupu ime nyocha ọbara ọbara maka glycosylated hemoglobin ekwesịghị ịrụ, n'adịghị ka nnwale maka ọkwa shuga. Ogologo mkpebi siri ike nke ihe ngosipụta a nke ụlọ nyocha maka ọrịa mellitus bụ otu maka ụmụ nwoke na ụmụ nwanyị, yana oge nke ọnwa abụọ ruo ọnwa atọ maka ụdị nke m, ọnwa 6 maka ụdị nke II. N'ime ụmụ nwanyị dị ime - jiri akara shuga kwadebe na izu nke 10-12 dị ime.

Ntughari nsonaazụ nyocha

Ọ bụrụ na ị nwere mmasị na ajụjụ nke ihe haemolobin glycosylated gosipụtara, mgbe ahụ ịkọwapụta ụkpụrụ nke nyocha ahụ iji chọpụta ọkwa nke HbA1C abụghị ihe siri ike. Mmụba ya site na 1% site na iwu kwekọrọ na mmụba nke ịba ụba site 2 mmol / L. A kọwara ụdị HbA1C na ọkwa glucose na ọnọdụ nke metabolism metabolism na tebụl glycosylated haemoglobin gosiri n'okpuru:

Ogologo mgbanye glucose na ọnwa atọ gara aga, mmol / l

Gịnị bụ haemoglobin glycosylated

Ichebe shuga ọbara adịghị mfe, ọtụtụ ụzọ na-enyekarị nsonaazụ na-ezighi ezi. N'ime nhọrọ kachasị dị mfe ma dị irè bụ nyocha glycosylated. Ihe omumu a kwesiri ntukwasi obi karia glucose di n’ime obara.

Glycosylated haemoglobin bụ ihe na-ekpebi nkezi shuga ọbara n’ime ụbọchị 120 gara aga. Kama okwu "glycosylated", "glycated" nwere ike iji. Ebumnuche ndị a bụ okwu okwu, ha abụọ na-egosi haemoglobin metụtara glucose.

Maka ndị nwere ahụike na ndị ọrịa shuga, mmụba nke ọnụọgụ glycogemoglobin dị n'ọbara bụ oge aga ụlọ ọgwụ. Dọkịta ga-edenye gị usoro ọgwụgwọ ma ọ bụ dụọ gị ọdụ ka ị rụọ ọrụ na mgbanwe ndụ. Iji gbochie ọrịa ahụ, ha na-enye nri pụrụ iche, na nnabata nke ịkwesiri ị rie naanị nri ahụ nwere obere carbohydrates.

Forzọ maka inyocha ọkwa shuga site na ịchọpụta haemoglobin glycosylated dị irè. Agbanyeghị, ọ ka nwere otu ọghọm: a na-ebelata ịdị irè ya ma ọ bụrụ na ejiri ọbara mee ihe ọ bụla.

Iji maa atụ:

• ọ bụrụ na onye ọrịa ahụ ekere òkè n’amịnye ọbara, ọbara ọbara ọbara ahụ na-enye ọbara n’onyinye na onye e nyefere ya ọbara ga-adị iche,
• nsonaazụ ụgha na-apụta mgbe obara na obara obara ya,
• mgbakwunye ụgha nwere ike ịnọchi anya enweghị ụkọ iron.

Ckinglele glycogemoglobin ga - enyere aka ma ọ bụrụ:

• ọ bụrụ na ọkwa shuga nke onye nnwale ahụ dị n'aka nri,
• mgbe onye ọrịa ahụ anaghị eso nri maka ọnwa 3-4, na otu izu tupu ọmụmụ ihe ahụ ọ kwụsịrị iri carbohydrates na-emerụ ahụ, na-enwe olileanya na ọ dịghị onye ga-ama banyere ya.

Mgbe ịchọtachara ọrịa, gwa dọkịta. Ọkachamara ahụ ga-agwa gị ugboro ole kwesịrị ịnwale maka ọgwụgwọ nyocha. Ọ bụrụ na onye ọrịa adịghị eme mkpesa maka ihe ọ bụla, ụbọchị ndị nleta ụlọ ọrụ na endocrinologist ka dọkịta depụtara. Oge ndụ erythrocyte na-ekpebi ugboro ole ọmụmụ glycogemoglobin na-amụ. A ga-eme nke a ụbọchị ọ bụla na ụbọchị iri abụọ.

Ọ bụrụ na enweghị mkpesa ma ọ bụ mgbanwe na-adịghị mma, mgbe ahụ ọ nweghị uru ịga leta dọkịta ọtụtụ mgbe.

• na ndị na-eto eto, glycohemoglobin kwesịrị ịbụ nke na-erughị 6.5%,
• maka etiti ha - ihe kariri 7%,
• maka ndị agadi - 7.5%.

Agbanyeghị, ọ bụ ihe amamihe dị na ya ikwu maka ọnụọgụ ndị dị otú ahụ ma ọ bụrụ na ndị ọrịa enweghị nsogbu yana enweghị ọghọm hypoglycemia. N'okwu ọzọ, ihe ngosi ahụ kwesịrị ịrị elu site na 0,5% maka udi ọ bụla.

Nsonaazụ abụghị onye ọrịa n'onwe ya. Ekwesịrị ime nyocha ahụ n'otu oge na nyocha nke glycemia. Ogo nke glycogemoglobin na ụkpụrụ ya anaghị ekwe gị nkwa na ọkwa agaghị agbanwe nke ọma ụbọchị niile. Maka imeỌkwa nke glycohemoglobin n'ime ụmụ nwanyị ndị a nwere ike ịdị iche na oke, n'ihi na ahụ nne na-arụ ọrụ maka onwe ya na nwa.

A na-ahụ ihe ngosi ndị a dị ka ihe dị mma:

• ruo afọ 28 - ruru 6.5%,
• site na afọ 28-40 - ruru 7%,
• Afọ 40 na karịa - ihe ruru 7.5%.

Ọ bụrụ na nwanyị dị ime nwere ogo nke glycohemoglobin nke 8-10%, nke a na-egosi ngbanwe ma chọọ ọgwụgwọ.
Ntụle maka shuga nke nne dị ime kwesịrị ịbụ ihe amanyere nwa na ọtụtụ oge n'oge afọ ime ahụ, riri nri tupu usoro ahụ n'onwe ya. Maka umuakaNormkpụrụ nke glycogemoglobin n'ime ụmụaka bụ nha anya okenye ma bụrụ 5-6%. Ihe dị iche bụ naanị na idobe ọnụego dị elu. Ọ bụrụ na a gbatuo ya nke ọma, nwa ahụ nwere ike inwe nsogbu anya.
Ekwesịrị icheta: ahụ ụmụaka ahụ esighi ike nke ukwuu ya mere a chọrọ usoro pụrụ iche maka ya. Maka ndị nwere ọrịa shugaỌ bụrụ na emere nchọpụta ahụ, ọrụ bụ isi nke onye ọrịa bụ idobe ihe ngosi ahụ n'ime 7%. Nke a adịghị mfe ma onye ọrịa ahụ ịtụle ọtụtụ atụmatụ.
Iji mezuo ọrụ nke igbochi uto nke ọkwa shuga ka a na-eji:

• insulin (mgbe odi nkpa)
• na-agbaso nri siri ike,
• nyocha ugboro ugboro
• eji glucometer.

Usoro nke glucose na-achị n’aka ụmụ nwanyị n’oge atụrụ ime

N'agbanyeghị uru dị na nyocha glycogemoglobin, ọ ka mma maka ụmụ nwanyị dị ime ime ya, n'ihi na nsogbu nke ịba ụba glucose ọbara na-abụkarị mgbe ọnwa nke isii gasịrị. Otu nyocha ahụ ga - egosi mmụba ka ọnwa abụọ gachara, nke dị nso na ọmụmụ nwa n’onwe ya, ọ bụrụ n’ịgosipụta oke, usoro iji belata ha agaghị enwe isi.

Ọ bụrụ na inye onyinye n'ụtụtụ na afọ efu, nsonaazụ ya ga-abaghị uru: ọkwa glucose na-abawanye mgbe ị risịrị nri, na mgbe awa 3-4 gasịrị, ọnụego ya dị elu nwere ike imetụta ahụike nke nne. N'otu oge, ileba shuga ọbara dị oke mkpa.

Ihe kachasị amara bụ ule nyocha ọbara ọbara n’ụlọ. Izuchara onye nyocha ahụ, ị ​​nwere ike duzie nnwale n'ụlọ mgbe ọkara elekere, 1 na elekere abụọ gachara. Ọkwa ekwesịghị ịdị elu karịa 7.9 mmol / l, mgbe ọ dị elu, nke a chọrọ ka ya na dọkịta nwee oge.

Ihe ngosi maka omumu

Glycosylated haemoglobin bụ ogige nke kwesịrị idobe ụkpụrụ ya mgbe niile.

Ihe ngosi maka omumu a bu:

• nnyocha shuga na nchọpụta shuga,
• na-elele nchịkwa nke hyperglycemia ogologo oge na ndị nwere ọrịa shuga,
• mkpebi siri ike nke ọrịa shuga kwụrụ ụgwọ,
• enwere ikike nnabata glucose,
• nyocha nke ụmụ nwanyị n'ọnọdụ ha.

Ekwesịrị ime nchọpụta nke Glycogemoglobin na ngosipụta ndị a nke ọrịa shuga:

• ọnụ kpọrọ nkụ
• ọgbụgbọ
• na-enweghi oke ibu,
• adịghị ike
• ike ọgwụgwụ
• mmetụta nke akpịrị ịkpọ nkụ ma ọ bụ agụụ,
• gbaa ume ka akpochapu igba otutu oge,
• na-agwọ oke ogologo
• akpụkpọ ọrịa
• mmebi anya
• na-akụ aka na ụkwụ.

Etu esi akwadebe maka nyocha

Otu uru isi nke nyocha glycogemoglobin bụ enweghị nkwadebe pụrụ iche.

Nsonaazụ rụpụtara arụpụtara onwe:

• ọnọdụ mmetụta uche
• ibu
• ị medicationsụ ọgwụ, gụnyere ọgwụ nje
• oyi na ọrịa
• na-eri nri na oge tupu ma ọ bụ mgbe ọ gasịrị,

Nkwadebe niile maka usoro a na-emetụta omume dị mma na ịnata ntụziaka site n'aka dọkịta ma ọ bụrụ na ọ dị mkpa.

Normalization nke haemoglobin nke glycosylated

Enwere ọtụtụ ụzọ iji belata ogo glycogemoglobin gị. Mfe kachasị n’ime ha bụ iji ọgwụ pụrụ iche ndị dọkịta depụtara depụtara. Kae sɛ, bere biara a yebehu nea enti a ɛte saa. Isi ihe kpatara na ịba ụba ma na -ebelata ọkwa shuga bụ nri na nri ruru eru.

Dabere na otu nnyocha, ụdị shuga 2, na-ebelata ọkwa hemoglobin nke glycemic, bụ 1% na-adịkarị mfe nkụda obi, cataracts.

Iji mee ka ọkwa nke glycogemoglobin dị gị mkpa,

1. Belata nri nke nwere carbohydrates na nri (na-abawanye ụba) ma gbanye (na nke belata).
2. Iri akwukwo nri na nkpuru osisi (puere unere), ọka di nma.
3. Jụ carbohydrates nụchara anụcha - ihe ndozi, achịcha ọcha, ihe achọrọ, achịcha, soda, ihe dị iche iche na-atọ ụtọ. Ọ bụrụ na ịnweghị iwepu ha kpamkpam, ị ga-anwa iri obere nri ma ọ bụ jiri ngwaahịa ndị sitere n'okike dochie ya.
4. Iji tinye ngwaahịa mmiri ara ehi dị obere kalori na nri, nke a ga-akwado ọnụnọ nke calcium na vitamin D n’ahụ.
5. Ghaa abụba akwukwo nri, mkpụrụ ga-aba uru karị.
6. Jiri cinnamon dị ka ihe ji esi mmiri, ma ọ bụghị ihe karịrị 0,5 tsp. kwa ụbọchị.
7. Gbaa mbọ hụ na ịgbaso servings.

Anotherzọ ọzọ dị irè isi weghachi shuga na ndụ bụ ịnọgide na-ebi ndụ.

Ugboro ugboro:

• nyere aka wepu oke kalori,
• mee ka akwara gbasie ike,
• belata ohere nke ịda mba na nrụgide,
• na ekele ha, ahụ ga-adịgide na-adị mma.

Ighaghari mgbe nile na ikuku ohuru di nkpa. Maka ndị contraindicated na mmega ahụ, a na-atụ aro ijegharị Nordic, igwu mmiri, yoga, mmega iku ume na ntụgharị uche.

Kpachara anya na usoro ihe omume a dị mkpa n'ihe niile. Nke a metụtara ọzụzụ, nri na ụra, oge ọgwụ na nyocha. Oge nyocha dị otú ahụ na-enyere onye ọrịa ahụ aka ịchịkwa na ịchịkwa ọ bụghị naanị glycogemoglobin, kamakwa ndụ ya n'ozuzu ya.

E nwekwara ụzọ ọgwụ iji gbochie nsogbu nke ọrịa a na iji belata ogo nwere protein glycated.

Nzọụkwụ ndị a dị ka ndị a:

• Nkwado nrụgide na ọkwa nke 140/90 mm RT. Art.,
• ịhazi ọkwa abụba ka ọghara ibute mgbanwe atherosclerotic na arịa ọbara,
• nyocha nke afọ nke ọhụụ, irighiri akụrụ, akụrụ na ụkwụ. Ọrịa ahụ kwesịrị ịchịkwa ọdịdị nke ụkwụ ya, ọkachasị maka ọnụnọ ọnya, ịcha ọbara ọbara ma ọ bụ ọnya ahụ, ahịhịa, corns na ọrịa fungal dị iche iche.

Ekwesịrị ịme nyocha ahụ ugboro atọ n'afọ, na-echeta na ọmụmụ ihe a abụghị ihe nnọchi anya iji chọpụta ọkwa glucose na glucose ot na ọ dị mkpa itinye usoro abụọ a n'ụzọ zuru oke. A na-atụ aro ka iwelata ihe ngosipụta nke nta nke nta - ihe dịka 1% kwa afọ ma ọ dịghị agba mbọ maka ngosipụta izugbe nke 6%, mana maka ụkpụrụ dị iche maka otu afọ dị iche.

Mara ihe ngosi a (glycosylated haemoglobin), ọ nwere ike ịka mma ịchịkwa ọrịa ahụ, mee mgbanwe ndị dị mkpa maka ogo ngwaahịa nwere shuga na nhazi ndị dị otú ahụ nke ezubere iji belata shuga.

Usoro edemede: Mila Friedan