Glycated haemoglobin na nchọpụta ọrịa shuga

N'iburu n'uche nsogbu nke ọrịa shuga mellitus, enwere ike ịmalite na ngwa ngwa nke nsogbu ya, ọnụ ọgụgụ buru ibu nke nyochaghị ya na amụma na-akụda mmụọ nke WHO gbasara atụmanya maka mgbasa nke ọrịa shuga n'ụwa, nchọpụta oge na nke ziri ezi nke ọrịa metabolism metabolism dị mkpa. Glycated haemoglobin bụ ihe na-egosi na, mgbe ị na-eji usoro ọkọlọtọ eme ihe, na-eme ka echiche gbakọrọ agbakọ gbasara glycemia ogologo oge ma na-enyere aka ịchọpụta mmebi nke metabolism metabolism. Mgbe ị na-eji haemoglobin glycated dị ka ihe nchoputa maka nsogbu nke metabolism metabolism ma ọ bụ ogo nke nkwụghachi ụgwọ maka ọrịa shuga mellitus, ọ dị mkpa ịhọrọ usoro maka ikpebi ihe ngosi a na-eburu n'uche ntụkwasị obi nyocha ya.

Ọrụ nke Hemoglobin nke Glycated na Nchoputa na Nyochaa Ọrịa Shuga Mellitus

Cons> ọrịa shuga mellitus, enwere ike ibido na rap> ọrịa shuga mellitus na-agbasa n’ụwa, nchọpụta oge na ezi nrịịrịa nke ọrịa metabolism metabolism dị mkpa. Igwe ahụ haemoglobin bụ ihe na-egosi na, ka a na-eji usoro ọkọlọtọ eme ihe, prov> glycated hemoglobin dị ka usoro nyocha nke ọrịa carbohydrate metabolism ma ọ bụ ogo nke ọrịa shuga mellitus, ụzọ ziri ezi maka ịhọrọ usoro nke ntinye ntinye akwụkwọ a, na-atụle nyocha ya. ntụkwasị obi, dị mkpa.

Ederede nke ọrụ sayensị wee rụọ ọrụ na glycated haemoglobin na nchọpụta na nlekota nke ọrịa shuga mellitus

Kiev City Clinical Endocrinology Center

Ọrụ nke hemoglobin glycated na nyocha na nlegide nke ọrịa shuga mellitus

Nchikota N'iburu n'uche nsogbu nke ọrịa shuga mellitus, enwere ike ịmalite na ngwa ngwa nke nsogbu ya, ọnụ ọgụgụ buru ibu nke nyochaghị ya na amụma na-akụda mmụọ nke WHO gbasara atụmanya maka mgbasa nke ọrịa shuga n'ụwa, nchọpụta oge na nke ziri ezi nke ọrịa metabolism metabolism dị mkpa. Glycated haemoglobin bụ ihe na-egosi na, mgbe ị na-eji usoro ọkọlọtọ eme ihe, na-eme ka echiche gbakọrọ agbakọ gbasara glycemia ogologo oge ma na-enyere aka ịchọpụta mmebi nke metabolism metabolism. Mgbe ị na-eji haemoglobin glycated dị ka ihe nchoputa maka nsogbu nke metabolism metabolism ma ọ bụ ogo nke nkwụghachi ụgwọ maka ọrịa shuga mellitus, ọ dị mkpa ịhọrọ usoro maka ikpebi ihe ngosi a na-eburu n'uche ntụkwasị obi nyocha ya. Okwu dị mkpa: mellitus ọrịa shuga, hemoglobin glycated, glycation, njikwa glycemic.

Diabetes mellitus (DM) bu ezigbo nsogbu ogwu na ndi otu. Dị ka amụma WHO si kwuo, ka ọ na-erule 2030 ọnụ ọgụgụ ndị ọrịa na-arịa ọrịa shuga ga-agafe nde 592. Mana nsogbu a mejupụtara ọ bụghị naanị ọrịa shuga, kamakwa na mmepe ngwa ngwa nke nsogbu ndị na-ebute mbelata ogo ndụ onye ọrịa, nkwarụ na ọnwụ. Maka ndị ọrịa na-arịa ọrịa shuga, mmalite mmalite na ọtụtụ oge nsogbu nke vaskụla bụ njirimara: ya na ụdị 2 - macrovascular (mbibi nke akụkụ ụbụrụ, akwara na akụkụ) yana microvascular (retinopathy, nephropathy, neuropathy), ya na ụdị 1 - microvascular. Otu ihe banyere ụdị ọrịa shuga 2 bụ ọnụnọ nke nsogbu ndị na-adịghị ala ala n'oge ịmebe nyocha nke nyocha, nke na-eme ka ọrịa ahụ ka njọ ma na-agbagha ohere ịkwụghachi ya.

Ugbu a, nde ndị nde 1.3 na-arịa ọrịa shuga ka edebanyere aha na Ukraine. Ọzọkwa, data sitere n'ọmụmụ ihe gbasara ọrịa na-egosi na ọnụ ọgụgụ ndị ọrịa nwere ọrịa shuga na-achọpụtaghị ugboro abụọ 2-2.5 karịa ọnụ ọgụgụ ndị ọrịa a chọpụtara. Ya mere, maka endocrinologists, ndị na-agwọ ọrịa, na ndị dọkịta ezinụlọ, nsogbu nke ilebanye shuga shuga dị mkpa.

Otu n'ime ụzọ isi chọpụta nsogbu nke metabolism metabolism bụ ikpebi ọkwa nke glycemia. Ekwesịrị iburu n'uche na nsonaazụ ya na-egosipụta mkpụkọ glucose naanị

n'oge a na-anakọta ọbara, na glycemia ụkpụrụ nwere mgbanwe dị ukwuu n'ụbọchị. Yabụ, njikọ dị n'etiti ọkwa glucose a kapịrị ọnụ na ọkwa nke glycemia adịghị ike, yabụ ọ gaghị ekwe omume ikwubi na onye ọrịa ahụ nwere nsogbu metabolism nke ntụkwasị obi ma ọ bụ nke na - adịghị adị na - adị n'etiti nha. Nkwupụta nke WHO (2006) na-egosi na na 30% nke ikpe ọ gaghị ekwe omume ịchọpụta ọrịa shuga site na iji nkọwa nke glycemia na-ebu ọnụ.

Ihe ngosi nke na-enye echiche agwakọta nke ọkwa glycemia ogologo oge bụ glycated haemoglobin (L1L1c). Ọtụtụ ọmụmụ na-egosi njikọ dị n'etiti Lyb1c na ọkwa glycemia onye ọrịa 2, 3.

N'ime akwụkwọ sayensị na afọ ndị na-adịbeghị anya, otu echiche etolitela ihe dịka usoro abụọ yiri ka ọ dị - glycosylation na glycation. Glycosylation, ma ọ bụ kama, transglycosylation, bụ nnyefe nke nsị nke monosaccharide na monosaccharide ọzọ na njikọ nke njikọ glycosidic, nke bụ usoro enzymatic. Glycation (glycosylation na-abụghị enzymatic

ihe omuma) bu ihe nke na - abughi enzymatic nke ihe omimi nke monosaccharide nke amino nke protein (peptide ma obu amino acid) na ntinye nke Schiff, ma ketamine. Ọnọdụ ndị a dị mkpa maka usoro a: 1) ọnụnọ nke ìgwè MO2 na - enweghị akwụkwọ na protein, 2) ọnụnọ nke aldehydes, 3) oge kọntaktị zuru ezu, 4) ike nke protein iji gbanwee mgbanwe ngwa ngwa wee laghachi n'ọnọdụ mbụ ya. Nke ahụ bụ, okwu a kpọrọ "haemoglobin glycated" na-egosipụta n'ụzọ ziri ezi karịa usoro njikọ dị n'etiti haemoglobin nke mkpụrụ ndụ ọbara uhie na glucose. Iji gosipụta mgbakwunye shuga na protein na-abụghị enzymatic, ngalaba nkwonkwo nke IUPAC (International Union of Pure and Applied Chemistry) na-egosi na a ga-eji okwu ahụ glycation mee ihe, bụ nke kachasị mma maka okwu ahụ na-enweghị enzymatic glycosylation. E nwere ụdị dị iche iche nke hemoglobins glycated: LABA1a, HbA1b, HbA1c. Naanị HbA1c variant na-enye mmekọrịta na ogo nke ọrịa shuga. Usoro mgbanwe a na - agbanweghi agbanwe, ọsọ ya (yana ntinye nke HbA1c) bụ ihe dabara adaba na ọkwa glycemia.

N'ime ndị mmadụ nwere ahụike, ịba HbA1c n'ọbara sitere na 4 ruo 5.9%, n'ime ndị ọrịa nwere ọrịa shuga, ọkwa ya dabere na ogo hyperglycemia. Ihe mejupụtara HbA1c na-agbakọta n'ime mkpụrụ ndụ ọbara uhie wee dịgide na ndụ niile nke sel ọbara ọbara. Ebe ọ bụ na mkpụrụ ndụ ọbara uhie na-agagharị n’ọbara nwere afọ dị iche iche, a na-atụ aro ka elekwasị anya na ọkara ndụ nke sel ọbara - ụbọchị 60. Ya mere, ntinye uche nke HbAk na-egosi ọkwa nke onye ọrịa glycemia ọkwa 60 (ruo ụbọchị 90) tupu ọmụmụ. Mmetụta kasịnụ na ọkwa HbA1 (, nwere ụbọchị 30 ikpeazụ tupu ị nyocha ahụ. Ọkwa glycemia n'oge a bụ n'ihi 50% nke uru HbA1 (,. Ya mere, uru nke ikpebi HbA1 (, na nke ahụ na-egosipụta ogo nke glucose n'ọbara ogologo oge.) oge, ya bụ, steeti carbohydrate metabolism n’ime ọnwa 2-3 gara aga.

Site na echiche nke uru ụlọ ọrụ, nkọwa nke HbA1c nwere ọtụtụ uru ma ọ bụrụ na e jiri ya tụnyere mkpebi siri ike nke glycemia:

- nsonaazụ nke HbA1c anaghị adabere na nri iri nri (enwere ike ikpebi ọ bụghị afọ efu), mmega ahụ, ọnọdụ akparamaagwa nke onye ọrịa,

- enwere ike ịme nlele ọbara n'oge ọ bụla: HbA1c kwụsiri ike n'ọtụtụ okpomọkụ na ogologo oge,

- ikike ichekwa ihe nlele ọbara iji chọpụta HbA1c na 2-8 Celsius C ruo ụbọchị asaa,

- nwere mgbanwe dị iche iche dị n’ime ala.

Enwere njikọ dị n'etiti ụkpụrụ HbA1c na ọkwa glycemia (pre- na postprandial), nke edopụtara na tebụl. 1.

Prettụgharị nsonaazụ nke HbA1c nwere ike isi ike. Gbasa ụkpụrụ HbA1c n'ime mmadụ abụọ nwere ọkwa glucose ọbara dị elu nwere ike iru 1%, nke a bụ n'ihi ọnụnọ nke ọdịiche na teknụzụ ụlọ nyocha na ọdịiche dị iche n'etiti ndị ọrịa. Nke a na-egosi ịdị mkpa nke ịhazi usoro nyocha.

Usoro nhazi nke usoro nyocha ọbara na-agbaze agba

Na nyocha nke HbA1c, ọ dị mkpa iburu n'uche usoro maka mkpebi ya na ntụkwasị obi nyocha nke usoro ejiri. Afọ ole na ole gara aga, enweghị usoro nhazi nke usoro iji tụọ HbA1c, nke belatara ịdị irè nke ụlọ ọgwụ iji ule a. Na 1993, American Clinical Chemistry Association mepụtara National Glycohemoglobin Standardization Programme (NGSP). Ugbu a, a na-achọ ndị na-emepụta sistemu maka HbA1c iji nwalee nnwale ma nweta asambodo DCCT nke nnabata (DCCT - Njikwa ọrịa shuga na Ọnwale Ọnọdụ). Ndị otu American Diabetes Association (ADA) tụrụ aro ka ndị ụlọ ọrụ nyocha niile jiri naanị NGSP 6, 7. Ezigbo ihe achọrọ maka ụzọ NGbị maka ịchọpụta HbA1c bụ ịmụpụtagharị na nwere ọnụọgụ mgbanwe (CV) erughị 4%. O di nwute, uzo eji eme na laborat laboati adighi ezuta ihe ndi a. CV dị ala dị oke mkpa ma ọ bụrụ n'ọbara ọbara HbA1c nke onye ọrịa dị nso na oke edobere maka nkwụghachi DM. Uru CV kariri 5% na - eme ka o kwe omume iji nkọwa nke HbA1c mee ihe maka nyocha, ebe ọ ga - eduga na nchọpụta ụgha na - adịghị mma.

Ruo taa, a na-ama ihe karịrị ụzọ 20 maka ịchọpụta HbA1c. Dika ogbako, enwere ike ekewa ha na chromatographic (chromatography fluid, chromatography affinity), electrophoretic, immunochemical, colorimetric. Eachzọ nke ọ bụla nwere uru na ọghọm ya (tebụl. 2).

Tebụl 1. Nrube isi na ụkpụrụ HbA1c

na ọkwa glucose plasma plasma

HbA1c,% glucose plasma glucose, mmol / L Plasma glucose awa 2 mgbe nri, mmol / L

Enweghị m ike ịchọta ihe ịchọrọ? Gbalịa ọrụ nhọrọ akwụkwọ.

2) ndu n’ile (ndu anya). Echiche a na - enyere gị aka inyocha ọnọdụ onye ọrịa na ohere nke ịmalite nsogbu vaskụla (ọbụlagodi karịa afọ). Yabụ, ebumnuche nke nchịkwa glycemic nwere ike ịbụ obere ihe na ndị ọrịa nwere atụmanya ndụ nke 10%), C na S

Chromatography obere nsogbu ion mgbanwe chromatography - Ezi mmekọrịta na HPLC - Mkpa maka ịkwadebe atụ - obere nrụpụta, nnyonye anya na ọnụnọ nke HbF

Microcolumn chromatography chromatography - Nke dị ọnụ ala dị ala - - Nwetaghị ihe NGSP chọrọ - Ọnụ ahịa ego dị elu

Isiokwu 3. Ebumnuche nke ọgwụgwọ na ọgwụgwọ nke ọrịa shuga 2

Ihe mgbaru ọsọ Ọgwụgwọ (nsonaazụ ụlọ nyocha)

wdg,% 1c 'Oke a nabatara maka ndị ọrịa niile bụ enweghị m ike ịchọta ihe ịchọrọ? Gbalịa ọrụ nhọrọ akwụkwọ.

4) ihe ize ndụ nke ịmalite hypoglycemia siri ike. Ohere nwere ike ịchịkwa usoro glycemic bụ ihe a kpaara n'ihi na ọ na-eweta oke ohere nke ọnwụ obi.

Ebumnuche ọgwụgwọ na ọgwụgwọ nke ọrịa shuga 1

Dika ntuziaka ndi di ugbua (ADA, 2013), uru nke HbA1c achoghi m ihe ichoro? Gbalịa ọrụ nhọrọ akwụkwọ.

0-6 enweghị m ike ịchọta ihe ịchọrọ? Gbalịa ọrụ nhọrọ akwụkwọ.

1. International Diabetes Federation, ọrịa shuga. - 6h ed. // International Diabetes Federation. - 2013. - 159 rubles.

2. Gonen B.A. Hemoglobin A1: Ihe ngosipụta nke usoro metabolic nke ndị ọrịa mamịrị / B.A. Gonen, A..H. Rubinstein, H. Rochman et al. // Ndị Lancet. - 1977. - Vol. 310. - P. 734-737.

3. Koenig R.J. Mmezi nke glucose iwu na haemoglobin Ac na ọrịa shuga mellitus / R.J. Koenig, C.M. Peterson, R.L. Jones et al. //

New England Journal ofMedicine. —1976. - Vol. 295, Nke 8. - R. 417420.

4. Korolev V.A. Izọ Isoelectrofocusing na photocolorimetry maka ikpebi haemoglobin A1c / V.A. Korolev,

B.I. Molchanov // Ngwukwo ogwu nke Biomedical. - 2006. - T. 52, Nke 2. -

5. Peters-Harmel E. Ọrịa shuga: nchọpụta ya na ọgwụgwọ / E. Peters-Harmel, R. Matur: Trans. si na bekee - M .: Omume, 2008 .-- 496 p.

6. American Diabetes Association Standards of Nlekọta Ahụike na Diabetes - 2010 // Nlekọta Ọrịa shuga. - 2010 .-- Vol. 33 (1). - P. 511-561.

7. Kọmitii ọkachamara na mba ụwa na-akọ banyere ọrụ Ac assay na nyocha nke ọrịa shuga // Nlekọta Ọrịa shuga. - 2009. - Vol. 32 (7). - P. 1327-1334.

8. Usoro nnabata IFCC nabatara maka ịba HbAlc n'ọbara mmadụ // Clin. Chem. Lablọ nyocha. Ọrịa. - 2002. - Vol. 40 (1). - R. 78-89.

9. DCCT. Mmekọrịta nke mkpughe nke glycemic (HbAlc) n'ihe egwu nke mmepe na ntolite nke retinopathy na njikwa ọrịa shuga na ọnwụnwa // Ọrịa shuga. - 1995. - Vol. 44 (8). - P. 968-983.

10. Stratton J.M. Mkpakọrịta nke glycaemia nwere nsogbu ụkwara akwara na microvascular nke ụdị shuga 2 (UKPDS 35): atụmanya, ọmụmụ nlere / J.M. Stratton, A.I. Adler, A.W. Neil et al. // BMJ. - 2000. - Vol. 321. - P. 405-412.

11. Gnudi L. Nsonaazụ na mmetụta nke ACCORD na ADVANCE / L. Gnudi // Olu Diabetes. - 2009. - Vol. 54, Nke mbụ 1. - S. 29-32.

Kivsky Moscow 1 ^

NKE AKWEMKWỌ AH GRLU HEMOGLOGUS DIAGNOSTICS NA AKWTHKWỌ AH OFA NA-EKWU EGO.

Nchikota Na urachuvannyam ọrịa shugavogo zuru ụwa ọnụ, ị nwere ike ịmalite ngwa ngwa na ngwa ngwa nke osooso a, nnukwu! Nsogbu nyocha nke Yulkosp na amụma ndị na-abụghị nke anụ ahụ na WHO. Enwere ọtụtụ atụmanya maka ọrịa mellitus zuru oke na SVT, nke dị mkpa ma zie ezi, nyocha ọfụma nke mbibi nke osisi carbohydrate. Glashanov haemoglobsh bụ ihe na-egosi na-enye ohere maka nhazi nke ụzọ iji nye ọkwa nke glms maka ọrịre maka nnukwu oge, a na-ahapụ gị ka ị hụ ụdị carbon ndị mebiri emebi ozugbo. N'ihe banyere mmeri hemoglobe na-enwe mmeri, dị ka nkọwa nyocha, mee ka ike gwụ carbohydrate ma ọ bụ ọbụna usoro nkwụghachi nke ọrịa mellitus. kasị elu

Okwu gbara ọkpụrụkpụ: ọrịa shuga ụbụrụ, hemoglobch glomerular, gl kuvannya, njikwa glycemic.

Kyiv Municipal Clinical Endocrinological Center, Kyiv, Ukraine

NKE EGO NA-EKWETA HEMOGLOBIN N’IHI DIAGNOSIS na nlebara anya nke ndị ọrịa MELLITUS

Nchikota N'iburu n'uche njupụta nke ọrịa shuga mellitus, enwere ike ịmalite na ngwa ngwa nke nsogbu ya, ọnụ ọgụgụ buru ibu nke nyochaghị na nyocha na-akụda mmụọ nke Healthtù Ahụ Ike onwa na atụmanya nke ọrịa shuga mellitus na-agbasa n'ụwa, oge kwesịrị ekwesị na nchọpụta nke metabolism metabolism. ọgba aghara dị mkpa. Igwe ahụ haemoglobin ahụ bụ ihe na-egosi na, ka a na-eji usoro ọkọlọtọ arụ ọrụ, na-enye echiche na-agbanwe agbanwe nke oke glycemia n'oge ogologo oge ma na-enyere aka ịchọpụta nsogbu metabolism metabolism n'oge. Ka ị na-eji haemoglobin gly dị ka usoro nyocha nke nsogbu nke carbohydrate metabolism ma ọ bụ ogo nke ọrịa shuga mellitus, ụzọ ziri ezi maka ịhọrọ usoro nke mkpebi a, na-atụle ntụkwasị obi nyocha ya, dị mkpa.

Okwu dị mkpa: mellitus ọrịa shuga, hemoglobin glycated, glycation, njikwa glycemic.

Atụmatụ nyocha

Mkpụrụ ndụ ọbara ọbara nwere ọbara-ọbara hemoglobin A. Ọ bụ ya bụ onye, ​​mgbe ejikọtara ya na glucose ma na-enwe usoro mmeghachi omume kemịkal, na-aghọ hemoglobin glycosylated. Ọsọ nke “nchigharị” a sitere na ọnụọgụ egosi shuga n'oge mkpụrụ ndụ ọbara ọbara ka dị ndụ. Usoro ndụ nke mkpụrụ ndụ ọbara uhie dị ụbọchị 120. Ọ bụ n'oge a ka a na-agbakọ ọnụọgụ HbA1c, mana mgbe ụfọdụ, iji nweta nsonaazụ kacha mma, ha na-elekwasị anya na ọkara ndụ usoro mkpụrụ ndụ ọbara uhie - ụbọchị 60.

Thedị ndị a na-ahụkarị na haemoglobin glycosylated bụ:

Dabere na ọnụ ọgụgụ, ọkwa nyocha maka ihe ngosi a adịghị agafe 10% nke ọrịa niile, nke abụghị eziokwu maka mkpa ọ ghọtara. Nke a bụ n'ihi ezughi oke ihe ọmụma nke ndị ọrịa banyere uru nyocha nke nyocha ahụ, ojiji nke ndị na-enyocha obere ihe na obere ihe na-ezughị ezu na nyocha na-ezughị ezu na mpaghara ụfọdụ, nke na-eme ka ntụkwasị obi ndị ọkachamara na ule ahụ ghara ịba ụba.

Isnye ka e kenyere nyocha?

Nchịkwa dị mkpa ọ bụghị naanị maka ọrịa shuga, kamakwa maka ndị nwere ezi ọrịa nke nwere ike ibute oke ibu na ọbara mgbali elu. Usoro nchọpụta a na-egosiputa nyocha nke oge a:

• mmadụ niile mgbe afọ iri anọ na anọ (afọ 2-3 ọ bụla, ọ bụrụ na nsonaazụ mbụ ahụ dị mma),
• ndị ọrịa nwere ndị ikwu nwere ọrịa shuga
• ndi mmadu na ebi ndu ha,
• ndị nwere nnabata glucose
• withmụ nwanyị ndị nwere ọrịa shuga,
• umunwanyi ndi nwere akuko banyere macrosomia
• ndị ọrịa polycystic ovary syndrome,
• ndị ọrịa na-arịa ọrịa shuga mellitus (nke mbụ ebutere megide mmalite nke mmepe nke nnukwu nsogbu),
• ya na ogwu ndi ozo (ya na oria Hisenko-Cushing, acromegaly, thyrotoxicosis, aldosteroma).

Kwadebe maka nchịkọta ihe adịghị mkpa. Ekwenyeghị nnwale maka mkpebi siri ike na haemoglobin maka ụmụ ọhụrụ ruo ọnwa 6.

Uru Nchoputa

Emegosiputara ogwu n’enyocha ihe omumu na mgbe obia n’aria ndi oria mmikpo na-ebelata ohere enwere nsogbu, ebe o kari ike inyocha ma mezie ugwo a.

Site n'ụdị insulin dabere, a na-ebelata ihe ize ndụ nke retinopathy site na 25-30%, polyneuropathy - site na 35-40%, nephropathy - site na 30-35%. Site n'ụdị insulin na-anaghị akwụ ụgwọ, ihe egwu nke ịmalite ụdị ọrịa angiopathy belatara site na 30-35%, nsonaazụ na-egbu egbu n'ihi nsogbu nke "ọrịa na-atọ ụtọ" - site na 25-30%, infarction myocardial - site na 10-15%, yana ọnụ ọgụgụ zuru ezu - site na 3-5%. Na mgbakwunye, enwere ike ịme nyocha n'oge ọ bụla, n'agbanyeghị nri nri. Ọrịa ọnya anaghị emetụta omume nke ọmụmụ ihe a.

Ofkpụrụ nke egosi na ọbara

Nsonaazụ nchọpụta a na-egosi na laabu ebe edere na%. Onu ogugu di otua na pathology di otua:

• ruo 5.7 - na-egosi ezigbo metabolism, anaghị achọ usoro ndị ọzọ,
• dị elu karịa 5.7, mana n'okpuru 6.0 - ọ dịghị “ọrịa na-atọ ụtọ", mana mgbazi nke nri dị mkpa, ebe ọ bụ na ihe egwu nke ibute ọrịa na - eto eto,
• dị elu karịa 6.0, mana n'okpuru 6.5 - ọnọdụ nke ọrịa shuga ma ọ bụ ịnagide glucose,
• 6, 5 na elu - nchoputa nke oria di n’ahia.

Ngosipụta Mgbapụta

Nchoputa banyere aru ike ọgwụgwọ maka ụdị ọrịa shuga 1 nke ọrịa shuga na glycated:

• n'okpuru 6.1 - ọrịa adịghị,
• 6.1-7.5 - ọgwụgwọ dị irè,
• dị elu karịa 7.5 - enweghị ike ọgwụgwọ.

Nkwụghachi ụgwọ maka ụdị 1 na ụdị ọrịa 2:

• dị n'okpuru afọ 7 - ụgwọ kwụọ ụgwọ (akwụ ụgwọ),
• 7.1-7.5 - inye onyinye,
• dị elu karịa 7.5 - mbibi.

Ihe ọghọm nke ịmalite ọrịa angiopathies megide mmalite nke ụdị ọrịa shuga 2 dị ka ihe ngosi HbA1c:

• ruru ma tinye 6.5 - ihe ọghọm dị ala,
• dị elu karịa 6.5 - nnukwu ihe ize ndụ nke ịmalite macroangiopathies,
• dị elu karịa 7.5 - nnukwu ihe ize ndụ nke ịmalite microangiopathies.

Oge njikwa

Ọ bụrụ na a chọpụta ọrịa shuga na nke mbụ, a na-achọpụta ndị ọrịa dị otu a n’afọ. N'otu ugboro ahụ, a na-enyocha ndị na-ejighị ọgwụ ọgwụ maka “ọrịa na-atọ ụtọ”, mana na-achọ nkwụghachi ụgwọ site na usoro nri na ezigbo mmega ahụ.

N'ihe banyere iji ọgwụ hypoglycemic, nkwụghachi ụgwọ dị mma na-achọ ịlele ihe ngosi HbA1c otu ugboro n'afọ, yana ụgwọ adịghị mma - otu ugboro kwa ọnwa isii. Ọ bụrụ na dọkịta nyere ọgwụ insulin, a na-eme nyocha ahụ maka nkwụghachi ụgwọ dị mma site na ugboro 2 ruo 4 kwa afọ, na-ezughi oke - 4 ugboro kwa afọ.

Dị Mkpa! Ihe karịrị ugboro anọ iji chọpụta ọrịa ọ nweghị uche.

Ihe na-akpata mgbanwe

Enwere ike ịba ụba nke glycosylated haemoglobin ọ bụghị nanị na “ọrịa na-atọ ụtọ”, kamakwa megide ndabere nke ọnọdụ ndị a:

• haemoglobin nwa di elu na nwa amụrụ ọhụrụ (ọnọdụ ahụ bụ physiological mana ọ dịghị achọ mgbazi),
• ibelata nha nke iron n’arụ,
• megide ndabere nke ịwa ahụ ọnya anụ ahụ.

Mbelata uche nke HbA1c na-eme n'ọnọdụ ndị a:

• mmepe nke hypoglycemia (mbelata nke glucose ọbara)
• oke ọkwa nke haemoglobin nkịtị,
• Ọnọdụ mgbe obara ọbara gachara, mgbe usoro ọbara bidoro na-arụ ọrụ,
• hemolytic anaemia,
• ọnụnọ ọbara ọgbụgba na ọbara ọgbụgba nke oke ma ọ bụ nke na-adịghị ala ala,
• akụrụ ime
• mmịnye ọbara.

Dizọ nyocha na nyocha

A na-eji ọtụtụ usoro iji chọpụta glycated egosi haemoglobin; n'ihi ya, enwere ọtụtụ ndị nyocha akọwapụtara maka usoro nchọpụta ọ bụla.

Chromatography nke dị elu na - agbanwe chromatography bụ usoro nke kewara ihe dị mgbagwoju anya n'ime ụmụ irighiri ihe, ebe isi mmiri bụ mmiri mmiri. Jiri nyocha D 10 na Variant II. A na-eme nnwale a na laboraul laboratrat laboratis nke ụlọ ọgwụ mpaghara na nke obodo, ụlọ nyocha na-achọpụta ihe dị warara. Iszọ a gbaara nke ọma na akpaka. Nchoputa ihe omimi achoghi nkwenye ozo.

Immunoturbudimetry

Analyzọ nyocha dabere na atụmatụ oge ochie antiigen. Mmeghachi nke agglutination na-enye ohere ịmepụta nke mgbagwoju anya, mgbe ekpughere ihe ndị nwere lumines, nwere ike ikpebi n'okpuru photometer. Maka nyocha, a na-eji ọbara ọbara, yana ngwa ihe nchọpụta pụrụ iche na ndị nyocha ihe banyere biochemical.

A na-eme ụdị nyocha a na ụlọ nyocha nke ihe eji eme mmiri na nyocha nke usoro nyocha. Mwepu nke usoro a bụ mkpa maka nkwadebe akwụkwọ ntuziaka.

Chromatography mmekọrita

Researchzọ nyocha akọwapụtara nke ọma na njikọta nke protein na ụfọdụ ihe ndị sitere na Organic agbakwunye na gburugburu ebe obibi. Ndị nyocha maka nnwale ahụ - In2it, NycoCard. Usoro a ga - enyere gị aka ịchọpụta nyocha ọfụma na ọfịs dọkịta (nke a na-eji mba ndị dị na Europe).

A na-eji nnwale ahụ mee ihe na mpaghara dịpụrụ adịpụ, nwere ọnụ ahịa dị oke ọnụ nke oriri, ya mere, ọ bụghị ihe eji eme. Iskọwapụta nsonaazụ ndị a ka dibia bekee nyefere gị ya nyochara ihe a. Dabere na ndị egosipụtara enwetara, a na-ahọrọ usoro ndị ọzọ maka njikwa ndidi.