Alcoholic hypoglycemia - usoro mmepe yana otu esi ewepụ ya

A. Ihe omuma banyere izugbe.Mmanya na-aba n'anya bụ ihe na-akpatakarị hypoglycemia dị ukwuu n’etiti ụmụ ọhụrụ na ụmụaka ndị okenye. Nwatakiri nwere ike jiri nwayọ drinkụọ ihe ọholicụ anụ na-egbu egbu site na onye okenye n’oge oriri. N'okwu a, hypoglycemia na-abụkarị n'ụtụtụ echi ya. Mgbe ụfọdụ nne na nna na-enye nwa ha mmanya ma ọ bụ mmanya.

B. Pathogenesis. Ntughari mmiri nke ethanol na acetaldehyde bụ nke mmanya na-egbu egbu. Ihe mejupụtara enzyme a bụ NAD - ihe dị mkpa maka gluconeogenesis. Ethanol na - eduga na mmefu ngwa ngwa nke NAD na nnukwute mgbochi nke gluconeogenesis na imeju. Ethanol na - ebute hypoglycemia naanị mgbe agụụ nri dị awa 6-8 (mgbe iwere glycogen na imeju na - agwụ).

B. Ọgwụgwọ. Site na hypoglycemia dị nro ma ọ bụ nke na-adịghị ala ala, a na-enye nwata ahụ mmanya na nri bara ụba na glucose. A na-ewepụ hypoglycemia siri ike site na njikọta glucose intravenous. Mgbe ọgụ otu hypoglycemia na-alụ ọgụ ugboro ugboro, ọ bụrụ na emeela ka eziokwu nke ị factụ mmanya dị, ọ dịghị mkpa iji nyochaa nwa ahụ.

Viii. Ọgwụ hypoglycemia.Enwere ike ịmalite hypoglycemia site na iwebata insulin, ọgwụ na-ebelata shuga ma ọ bụ na nnukwu nke salicylates. Acid nke Valproic acid na ihe ndi omu ya mechiri atukpo nke abuba ajuju, nke n’eduba adighi ike gluconeogenesis na erughi nke parnitine. Acidụbiga acid acid ókè na usoro ya nwere ike igosipụta onwe ya dị ka hypoglycemia na-enweghị ketonemia na ketonuria, karịsịa mgbe agụụ.

Nlekọta insulin bụ otu ụdị imetọ ụmụaka. Ọ na - eme na ndị nne na nna na - enye nwa ahụ insulin, na - eche na ha nwere ọrịa shuga na - akpata ọrịa shuga mellitus. Hypoglycemia kpatara insulin na onodu hypoglycemic na-ejikarị ihe ọdịdọ na enweghị uche ma nwee ike ịgbagha ya na ụdị hypoglycemia ndị ọzọ.

IX. Idiopathic repo hypoglycemia - ụdị hypoglycemia kpatara nri nri (leekwa isi nke 34, p. VIII). A na-enyo ụdị ụdị hypoglycemia a anya na ụmụaka na ndị nọ n’oge uto, mana ọ na-esikarị ike ịchọpụta nchoputa ahụ. Nchoputa nke idiopathic reactive hypoglycemia bu nke emere na ngbanwe nke nnabata nnabata glucose: Oge ato ka ato gachara glucose n’onu nke 1.75 g / kg (kacha 75 g), nnabata nke glucose na obara.

Ihe mmanya na-akpata na-akpata ọrịa hypoglycemic syndrome

Akparamagwa ethanol n’aru ọbara di iche-iche

• Nke mbụ, ọ na-eme ka ọrụ insulin na mbadamba shuga dị ala belata.
• Na-egbochi imeju, ethanol na-egbochi imepụta glucogen - ihe ọzọ na-enye glucose.
• Usoro nke ihe ọ alcoholụ alcoholụ na-aba n'anya yiri ọrụ nke lipids: na-agbari abụba, ọ na-eme ka ike gwụ mkpụrụ ndụ nke abụba. Site na mgbochi nke membranes, glucose sitere n'ọbara na-abanye sel. Mgbe ọdịnaya ya na sistemụ ikesa ọbara daa, agụụ na-apụtaghị ìhè.

Na mgbakwunye, ethanol na-agbazi arụmọrụ nke uto uto ma na-agbagha nzaghachi nke ahụ maka mgbanwe shuga plasma. Nke a bụ otu n'ime ihe ndị kachasị akpata hypoglycemia n'ime ndị na-a abuseụbiga mmanya ókè, n'ihi na homonụ na-eto eto na-achịkwa glucometer.

Site na kalori "efu" nke ethanol nwere, ọ na - egbochi itinye uru nke anụ ahụ.

Usoro mmepe nke hypoglycemia na-egbu egbu

Ndị ọrịa shuga nwere "ahụmịhe siri ike" nke ọrịa ahụ maara ike mmanya na-ebelata ike mmanya. Uzo glucose na ebili n’uzo abuo: site na oriri nke carbohydrates na nri ma site na imeju glycogen site na imeju. Nchịkọta glucose ike na-akwado ọkwa shuga nke opekata mpe 3.3 mmol / L. Ọ bụrụ na mmanya na - egbochi gluconeogenesis site na igbochi imeju, cheedị ihe na - eme anụ ahụ mgbe a na - enyeghị glucose. Ohere inweta inweta hypoglycemia dị elu karịa ndị ọrịa mamịrị na-arịa ọrịa shuga, ebe ọ bụ na ịhazigharị usoro iji tụlee ndị mmanya na-egbu adịghị mfe.

Ethanol na-akpata hypoglycemia n'ihi nkwụsị nke usoro gluconeogenesis na mgbanwe na cytosolic ruru NAD H2 / NAD. Alcohol Theụ mmanya na-egbu egbu n'ime imeju na-egbu mmụọ ịhydụ mmanya. Ihe mejuputara enzyme, NAD (nicotinamide adenine dinucleotide) bụ ihe dị mkpa nke glucogenesis. Ofụ mmanya na-aba n'anya n'ime sistem, na-akpata ike ọrụ nke NAD na imeju n'otu oge na-egbochi mmepụta glycogen.

N'ụzọ doro anya, mmanya hypoglycemia na-ebilite megide ndabere nke mbelata nke ihe ndị metụtara glycogen, mgbe ikike imeju glucogenesis dị ezigbo mkpa maka nhazi nke sugars. Ndị nọ n'ihe ize ndụ bụ ndị na-a aụ mmanya na-aba n'anya mgbe niile.

Nchoputa nke hypoglycemic steeti

Alcoholism bụ ihe ana-eme ugboro ugboro maka mmepe nke hypoglycemia maka ụdị ndị a na-arịa enweghị nchọpụta shuga mellitus. Na mbu, onu ogugu di otua nwere ihe omuma nke nwere ihe omuma di nma. Ma mgbe nyochachara ethanol dị ọcha, nke enyere ndị ọrụ afọ ofufo nwere ahụike ike, bụ onye nweburu agụụ ụbọchị abụọ ma ọ bụ atọ wee gosipụta ụdị ihe a, a ga-agbanwe echiche a.

A na-ahụkarị hypoglycemia n'etiti ndị hụrụ mmanya n'anya na-enweghị nri maka otu ụbọchị ma ọ bụ abụọ. Ọgba aghara bidoro na awa 6 ruo 24 mgbe ethanol batara n’ọbara, yabụ ọ bụ ihe ezi uche na-achọpụta nchọpụta banyere isi site n’ọnụ, ọmụmụ ụlọ nyocha dị mkpa. Enwere akụkọ banyere ihe mgbaàmà n'ụdị nke ọgbụgbọ ugboro ugboro, nke a na-egosi iwe nke sistem na afọ na mmanya na-egbu ya, mbelata calorie mgbe naanị nri ndị ahụ nwere ethanol na-abanye n'afọ.

Na ihe egwu, dị ka ihe kachasị nwee ike ịgwọ ọrịa hypoglycemic nke ị drinkingụ mmanya na-aba n'anya:

• Insulin na-arịa ọrịa shuga,
• Ndị ọrịa nwere ọrịa ọgbụgba-adrenal sistemụ,
• Whomụaka nwere ohere ị drinkụ mmanya n’amaghị ama.

Ihe egwu nke ọdịdọ na njirimara nke hypoglycemia dị maka ụmụaka na-erubeghị afọ ise. Let Theụ ọgwụ ethanol dị ọcha maka ụmụaka bụ 3 g / kg (na ndị okenye - 5-8 g / kg).

Mmanya na-akpata ịba ọcha n'anya na-akwụsịkarị na mmiri. O siri ike ịmata ọdịiche dị na steeti a na nsị na-egbu egbu.

Ejiri ụdị hypoglycemia nke ọrịa akara dị mkpa:

Nnwale ịba ọcha n'anya na-egosi usoro, ọ ga-ekwe omume ịchọpụta ọnọdụ ahụ naanị site na akụkọ ihe mere eme nke mmanya mmanya kwuru na anamnesis. Mgbe mweghachi nke akụrụngwa glycogen, ị alcoholụ mmanya na-egbu egbu anaghị akpata hypoglycemia.

Hypoglycemia na mkpọrọgwụ na-egbu egbu bụ ihe na-adabere na ya: ọ bụrụ na onye ọ na-eme ihe ọ bụla ewerela ya, a na-ebelata glucogenesis ogologo oge. Ihe dị egwu dịnụ bụ ọrịa hypoglycemia na-egbu oge. Ọ bụrụ na ọ inụrụ mmanya nke mgbede na mgbede, nsogbu nwere ike ịmalite n'abalị. N'ihi ntakịrị mkpụkọ nke glycogen n'ime imeju, ọnọdụ a siri ike ịgwọ. Mmanya na-egbu egbu na-eso eme ka ileghara ihe mgbaàmà nke hypoglycemia anya, ya mere, a naghị ewere usoro oge iji kpochapụ ha.

Otu esi ewepụ hypoglycemia mmanya na-egbu egbu

Enweghị nchoputa n'oge na ọgwụgwọ oge zuru oke, a hụrụ ọnwụ n'ime ọnọdụ a na 25% ụmụaka na 10% nke ndị okenye metụtara.

Mmeghe nke glucagon anaghị edozi nsogbu mmanya na-egbu egbu kpatara, ebe ọ bụ na enweghị glycogen nwere ihe ndị ọzọ, yana mmeghachi ahụ anụ ahụ na homonụ a. Inje glucose dị mma iji belata ọkwa lactate ma gbozie nguzogide acid. N'adịghị ka ụdị hypoglycemia, usoro onye ọrịa ahụ adịghị achọ infusion glucose na-aga n'ihu. N'ime ụmụaka nwere ụdị mgbaàmà a, ha na-ebido site na glucose, na dropper nwere mmiri glucose-electrolyte na-emeju ya.

Dika ihe mbu mbu (oburu na onye emeruru aru) ka enyere ya ohere iji carbohydrates n’iru - ihe uto, ihe uto di uto. A na-egbochi mmiri ọgwụ hypoglycemia site na obere carbohydrates. Mbadamba glucose nwere oke carbohydrates.

Thezọ kachasị mma iji kpochapụ hypoglycemic coma bụ igbochi:

1. Ndị ọrịa mamịrị kwesịrị belata ị alcoholụ mmanya.
2. Mmanya na-egbu egbu enweghị ike ịbụ ụzọ iji belata ọrịa glycemia.
3. Site na imeju dị mma, a na-ahapụ ya ka ọ rie 50 g vodka na cognac ma ọ bụ 150 mg nke mmanya akọrọ (isi ihe maka mmanya ahụ bụ enweghị shuga na obere kalori).
4. Mgbe ụfọdụ ị nwere ike ị drinkụ biya - ihe ruru 300 g (nsogbu ahụ sitere na carbohydrates na-akwụghachi ụgwọ site na uru nke yist).
5. A machibidoro ihe ọ drinksụ strongụ ọ strongụ strongụ ọ sweetụ --ụ na-atọ ụtọ ọ winụ --ụ - mmanya dị ụtọ na mmanya ndị e wusiri ike, ihe ọ liquụ liquụ, ihe ọorsụ liquụ wdg Maka ụmụ nwanyị dị ime, enweghị nhọrọ na nke a: a machibidoro mmanya na ụkpụrụ.
6. Cheta na mmanya na - e masomi ihe nrịba ama nke ịba ụba hypoglycemia, gụnyere igbu oge. Dọọ ndị ahụ nọ ugbu a nsogbu.
7. Ekwesịrị ị consumedụ ihe ọcoụcoụ na- egbu egbu nanị mgbe ị risịrị.
8. Tupu ị lakpuo ụra, dị njikere ịme nyocha shuga ọsọ ọsọ ma rie ihe nwere carbohydrates.
9. Mgbe ị na-agbakọ calorie nke nri gị, buru n'uche calorie nke mmanya: 1 g nke protein ma ọ bụ carbohydrates - 4 kcal, 1 g nke abụba - 9 kcal, 1 g nke ethanol - 7 kcal.
10. Jikere maka eziokwu ahụ bụ na mmanya ga-eme ka ịta ahụhụ triglycerides dị elu, mee ka ngosipụta nke mgbaàmà akwara pụta na nephropathy mamịrị.