Isi ihe mgbaàmà na-akpata lactic acidosis na ọrịa shuga

Ozi nke nkuzi nke Russian Federation

Mahadum Penza State

Nhazi nke MCA sitere na imebi ikuku oxygen n’akpụ anụ ahụ. Adị MCA pụtara nke ọma na akara ngosipụta nke hypoperfusion ma ọ bụ hypoxia, ụdị B gụnyere ụdị ndị ọzọ nke MCA na-enweghị akara nke anoxia anụ ahụ A na-ahụ maka ọgwụgwọ ahụ iji chọpụta ma mezie ọgba aghara ndị gara aga na ịmalite nguzozi acid-base.

A na-ebufe Babesiosis site na ịta ahụhụ ixodid nje nwere nje. Umu nwanyi ndi toro eto na –ebunye mwakpo ma buru kwa ndi transvaginal. Ozugbo ụmụ ọhụrụ ahụ batara n'ahụ onye nnabata ahụ, ha na-awakpo akpụkpọ ahụ erythrocyte ma bufee ya site na endocytosis. Akọrọ na-ebute ọrịa mgbe ị na-a meụ merozoites site na ịmịcha ọbara nke anụ nwere ọrịa.

Ihe na-egosi na ọria ọria bụ ịba, oke ikuku, yana oke anaemia, ebe ọrịa super-stroke nwere mmebi anụ ahụ yana nke ukwuu. Ọrịa oria bu ihe akparamagwa ahu nke anakpo anorexia, hemolytic anaemia, thrombocytopenia, lymph nodes, tobawanye amụba. Anorexia, lethargy, na ọgbụgbọ bụ mgbaàmà zuru oke. Ọbara hemolytic anaemia na system lupus erythematosus bụ ọrịa mbụ nke dị iche n'ụdị babesiosis a.

A na-ekeji MCA dika ihe ngosi putara ihe ma gosiputara ya n'uzo abuo. Dabere na nhazi ọkwa Cohen na Wood, ụdị A MCA pụtara na enwere ọgbụgba anụ ahụ (dịka ọmụmaatụ, ujo ma ọ bụ nnukwu hypoxia). Bdị B MCA gụnyere ụdị ndị ọzọ ebe enweghị akara nke ọgbụgba anụ ahụ (Isiokwu 1). A kọwara ICA na ntanetị, ma ọ bụ idiopathic, mana ugbu a ka a na-ajụ ịdị adị ya. Gmata mmụba na-arịwanye elu na ọrịa nke MCA nwere ike ime na-enweghị ụkwara anụ ahụ doro anya na-ewepụ ụdị a (i.e., idiopathic MCA). A kọwakwara usoro ọrịa metabolic ọhụrụ, D-MKA. A na-ahụ nke a n’etiti ndị ọrịa nwere obere eriri afọ ma ọ bụ n’ọrụ. Ọgwụ bakteria na-emepụta D-lactic acid, nke a ga-enweta ma na-eme ka abawanye na acidosis n'ihi oghere anionic, yana nzuzu ma ọ bụ coma. Plasma L - ọkwa lactate ka dị nkịtị. A na - enweta mmezi nke nsogbu nke metabolic site na iji neomycin ma ọ bụ vancomycin. A kọwara otu okwu nke D-MKA na onye ọrịa na-enweghị mmezi akwara ma ọ bụ ịrụ ọrụ nke obere eriri afọ.

Ọdịba ala na-arịa nwa na-enweghị usoro pụtara ìhè. Nnwale ụlọ nyocha nwere ike igosi ntakịrị ọkwa nhụjuanya hemolytic ọbara na thrombocytopenia. A na-ahụkarị ụdị ọrịa a na-adịghị ala ala, karịsịa na United States.

Nkịta na-enwe ọnyá dị nro, akpụkpọ ahụ na-acha uhie uhie, splenomegaly, ịba ọcha n'anya, ịmụba lymph na ọnya afọ. Enwere ike kee Babesiosis na nkịta na mgbagwoju anya na enweghị ike. Ihe anakpokoghi na ihe ngosiputa akuko nke banyere oria. Enweghi nsogbu - oria ahụ jikwa njọ na-adabere n'ịkpa ike nke pathogen na ọnọdụ nnabata nke ndị ọbịa. -Kpakọrịta na nje ndị ọzọ nwere ike iduga na ndagwurugwu foto na immunosuppression. Mụ anụmanụ nwere babesiosis na-enweghị nsogbu.

Pịnye Actic acidosis

Nke a bụ ụdị MCA kachasị elebara anya na SNPs, ọ na-abụkarị n'ihi ujo. Dịka egosipụtara, ụdị MCA a nwere ike ibute ọbara ọgbụgba, hypovolemic, cardiogenic ma ọ bụ ujo. Ndabere nke pathogenesis nke MCA n'ime ujo bụ ezughi oke anụ ahụ na-esote ya, na-esochi anoxia na nchịkọta nke lactate na hydrogen ion. Mkpochapu imeju na-ebelata n'ihi oke nke nsị na -akwụsị na akwara celiac na akwara hepatic na mmepe nke ischemia hepatocellular. Na pH nke ihe dị ka 7.0 ma ọ bụ nke dị ala, imeju na akụrụ nwere ike ịghọ akụkụ na-emepụta lactate.

Nwee ihe iriba ama nke anria metụtara hemolysis, tinyere ahu oku, anorexia, depression, pania mucous, splenomegaly. Enwere ike ịhazi mpempe akwụkwọ a dị ka nke ezi, agafeghị oke ma ọ bụ sie ike, dabere na nhụjuanya dị. Okwesiri iburu n’uche na enwere ike ibute ọrịa babesiosis na-enweghị nsogbu na ọrịa nwere ike ibute ọrịa anaemia na-eyi ndụ egwu.

Usoro Subclinical - na ụfọdụ nkịta, ụdị subclinical bụ nke juru ebe niile. Iji maa atụ, ọtụtụ nkịta nọ na United States bụ ndị seropositive maka babesiosis, mana ihe ịrịba ama nke ụlọ ọgwụ adịghị obere na nkịta okenye. Agbanyeghị, ndị na-ebunye subclinical egosighi ihe mgbaàmà nke nje bacteriosis, n’agbanyeghi na ọ nwere ike ha adịkarịghị enwe mgbaàmà nke nrụgide ma ọ bụ ọgwụgwọ glucocorticoid.

Mmekorita dị n'etiti ujo na MCA dị ezigbo nso nke na enwere ike ime nchọpụta nke MCA na nnukwu onye ọrịa na steeti ujo na mberede hyperventilation na ịba ụba acidosis n'ihi oghere anionic. Ọgwụgwọ bụ iji dozie ihe kpatara akpata oyi ujo. Fọdụ ndị nchọpụta achọpụtala na adịm ná mma dị n'etiti ọnụ ọgụgụ mmadụ na ọkwa ọbara dịkarịsịrị ala na ndị ọrịa akpata oyi. Ndị ọzọ na-ahụ maka njikọ a doro anya nke ọma, na ojiji nke ịta lactate dịka nyocha nke prognostic maka nsonaazụ ọrịa ahụ enweghị mgbagha. Dịka iwu, ka elu lactate ọbara, ka elu nke onwu.

Ha na-anyụ ara, na-arịa nri afọ. Nnukwu ọnya na jaundice bụ ihe mgbaàmà nkịtị. Ọbara bụ isi ihe kpatara mgbaàmà ụlọ ọgwụ. N'ọnọdụ ụfọdụ, ọrịa ahụ bụ nke na-adịghị ala ala, a na-ahụkwa ihe ịrịba ama naanị n'ọgwụgwụ nke ọrịa ahụ. A na-ejikarị nwamba naanị anaemia na ngosipụta dị omimi - ọrịa ahụ nwere ike ịka njọ site na nrụgide ma ọ bụ ọrịa concomitant. Nsogbu nke anaemia hemolytic gụnyere hepatopathies, akụkụ ụkwara ume ọkụ, akwara itule, ihe ịrịba ama nke sistem ụjọ, yana ọrịa nke abụọ.

Hypoxia nwekwara ike ibute ụdị A MCA, mana ọ ga-adịrị nnukwu ma sie ike. Enwere ike ichebe ndị ọrịa nwere ọrịa ngụgụ na-adịghị ala ala ma kwụsie ike site na ihe MCA site na usoro mgbanwe dị ka polycythemia, mbelata ọdịdị ọbara haemoglobin maka ikuku oxygen na mmụba na mmịpụta oxygen anụ ahụ.

MCA dị mkpa na ndị ọrịa dị otú a enweghị ike ịmalite ruo mgbe PO 2 na ọbara akwara ozi ruru 30 - 35 mm Hg. Art. N'ime ndị ọrịa nwere ikike dị ntakịrị iji kwụọ ụgwọ ọdịda okpu ume, MCA nwere ike ime na oke mgbatị akwara oxygen dị elu. Mmepe nke MCA metụtara ya na nnukwu ọrịa asphxia, ụkwara ume ọkụ, ọnọdụ nke asthmatic, akara nke ajọ ọrịa pulmonary na-adịghị ala ala na nchụpụ oxygen site na carboxyhemoglobin, sulfhemoglobin ma ọ bụ methemoglobin.

Nwamba nwere enzyme imeju dị elu na bilirubin dum. Ọgwụ: gwaa anụ ọgwụgwọ anụ. Mediclọ Ọrụ Ọgwụ na Europe kwubiri na a pụrụ iji ọgwụ ndị nwere metformin mee ihe n'ebe ndị ọrịa nwere ọrụ ịzụ ezumike nri na-agwọ ụdị ọrịa shuga 2. A ga-ewelitekwa ụdị ngwaahịa maka ọgwụ ndị a na ọgwụ contraindications, ha ga-ewekwa usoro onyonyo, usoro nlele, na akpachapụ anya na ndị ọrịa nwere ọrụ mkpolatalata.

Na mgbakwunye, ozi ngwaahịa dị ugbu a, nke dị iche na obodo na ngwaahịa na EU, anaghịzi agbaso ụkpụrụ nduzi ụlọ ọgwụ ugbu a. Metformin nwere ike ịbawanye ihe ọghọm nke siri ike a na-akpọ lactic acidosis, bụ nke na-ebilite mgbe mmepụta eke sitere n'okike nke lactic acid na-ewulite n'ọbara ngwa ngwa karịa ka enwere ike wepu ya. Ihe omuma ahia nke gara aga gosiputara na ekwesighi iji metformin mee ihe na ndi oria aru oru ha na-aru oru, ebe a na-ahuta ndi oria ndi a ka ha nwere nsogbu ibute lactic acidosis n'ihi ngosiputa nke metformin nke oma na akuru ha nke oma.

Bdị B lactic acidosis

Bdị nke B gụnyere ụdị MCA niile nke enweghị akara ngosipụta nke ọrịa ọgbụgba anụ ahụ. MCA nke ụdị a nwere ike ịmalite na mberede, n'ime awa ole na ole. Oria a na egbu oge n’abia n’ihi ihe adighi n’iru ya ma obu site n’amaghi nke dọkịta banyere nmekorita nke otutu oria na udiri oria B MCA amaghi nke oma. Site na nkọwapụta, ọrụ nke akụrụngwa akwara adịghị mma yana ọbara mgbali anaghị ebelata. Dị ka enwere ike ibute ọrịa, a na-atụ aro maka mpaghara Subclinical nke iwere anụrị anụ ahụ. N'ọtụtụ ọnọdụ ụdị B MCA dị oke njọ, a na-ahụta okirikiri okirikiri n'ọtụtụ awa mgbe ọ malitesịrị, nke na-eme ka ọnọdụ a ghara ịdị anya site na ụdị A MCA. A na-ekewa Bdị B MCA ụzọ atọ (B 1, B 2 na B 3).

Ebumnuche doro anya maka ịsingụ na nleba anya tupu yana n'oge ọgwụgwọ ezubere iwelata ihe ọ bụla nwere ike ibute ndị ọrịa a ike. Ngosipụta ihe dị iche na ndị ọrịa nwere ọrụ mgbazinye nsogbu dị ukwuu ga-adịgide. Companieslọ ọrụ ndị na-ere ahịa Metformin ga-akpachara anya nyochaa ma nyochaa okwu ọdịnihu nke lactic acidosis ma kọọ ha n'oge nyocha nchekwa oge na-abịanụ iji nyochaa mgbanwe enwere ike na ngbanye mmetụta a.

Bdị B gụnyere ụdị MCA na-ada megide nzụlite nke ọrịa ndị ọzọ, dị ka ọrịa shuga, ọrịa imeju na akụrụ, ọrịa, neoplasia na ọnọdụ nkwarụ. Onweghi nmekorita doro anya di n'etiti onodi oria n’ahia MCA, mana otutu ihe di n’etiti ha achotawo ya. Cohen na Woods kwuru na 10-15% nke ndị ọrịa mamịrị na ketoacidosis nwere ọnụọgụ lactate ọbara dịkarịa ala 5 mEq / L. Ọrịa ọnya nke MCA na-esonyere gụnyere nnukwu necrosis na cirrhosis. N'ọnọdụ ndị dị otú a, ihe kpatara MCA nwere ike ịbụ mbelata mkpụbelata lactate site na imeju n'ihi ezughi oke anụ ahụ n'oge gluconeogenesis. Ọrịa ịba ụba na-adịkarị ala na ICA na-esonyere ya, agbanyeghị, ọnụnọ nke mmekọrịta ọ bụla na-enwe obi abụọ. N'ime ụfọdụ ndị ọrịa nwere ajọ ọrịa, ọkachasị bacteremia, MCA na-etolite n'ihi ihe amaghi. Ọrịa dị na 27 nke 65 nke ụdị B MCAs nke Cohen na Woods nyochara. Lactic acidosis bu oria myeloproliferative dika oria leukemia, otutu myeloma, oria buru ibu na oria Hodgkin. Akwụkwụ na-adọ ụdị nne ochie nwere ike ibute mmepe nke MCA n'ihi oke ahụ ike yana, ikekwe, hypoxia. Kọwara okwu banyere MCA na Reye syndrome. Achọpụtara mmekọrịta dị n'etiti ọkwa dị na coma na ọkwa lactate n'ime ọbara.

A ga-emelite ozi ngwaahịa maka ngwaahịa nwere metformin iji gosipụta atụmatụ ọhụrụ yana iji hụ na enyere ndị ọrịa EU niile otu ndụmọdụ. Ozi maka ndi dibia bekee. Site na ntụle nke nchekwa nke ọgwụ nwere metformin, ekwubiri na enwere ike iji ọgwụ ndị a nwee ndị ọrịa nwere ọrụ mkpo ume arụ ọrụ na-adịghị ala ala. Ihe omuma nke ihe ahia nwere ihe omuma banyere ihe egwu nke lactic acidosis, nke ekwesiri ichoputa tupu ya na mgbe ogwoo ya. Na Europe, enwere ọtụtụ ngwaahịa nwere metformin na mkpokọ-akụkụ edoziri. Ọ bụrụ na eji ngwaahịa ndị dị otú ahụ na ndị ọrịa nwere ọrụ mgbazinye nsogbu, contraindications, ịdị irè na usoro nke ihe ọzọ na-arụ ọrụ n'ime ya, yana iji ọgwụ ọzọ nwere naanị otu ihe ọrụ, kwesịrị ka ewere ya. Agaghị atụ aro ka ụfọdụ ọgwụ ndị eji eme ihe nkwụ ya maka iji ndị ọrịa nwere obere ọrụ mkpo ya na-erughị ala, ebe akụrụngwa ndị ọzọ na-arụ ọrụ na mgbakwunye adịghị mma maka iji ha. Metformin bụ ọgwụ a na-eji naanị ya ma ọ bụ ya na ọgwụ ndị ọzọ iji gwọọ ọrịa shuga.

Ndi otu a gụnyere ụdị MCA sitere na ikpughe ọgwụ, ọgwụ na ọgwụ ahụhụ. N'oge gara aga, mpụta nke ụdị MCA a bụ nke metụtara na iji ọgwụ ọgwụ hypoglycemic ọgwụ phenformin, ma na - ewepụ ugbu a na orire na United States. Ethanol na-ejikọkarịkarị na MCA. N'ime oge ọidụ alcoholụ mmanya na-egbu egbu, ihe NADH na ọbara na-abawanye, nke na-eduga na itinye n'ọrụ nke pyruvate - lactate metabolic way n'oge oxidation ugboro ugboro nke NADH. N'oge mmeghachi omume a, ọkwa nke lactate dị n'ọbara na-abawanye ogologo oge. Na ọnụnọ nke ihe ndị ọzọ na - akpata MCA, ị alcoholụ mmanya nwere ike ịbawanye acidosis. Mpụta nke MCA metụtara ya na ojiji nke fructose, sorbitol, oke adrenaline na catecholamines ndị ọzọ, methanol na, ikekwe, saliylates. Ojiji nke otutu ogwu ndi ozo na nmekorita nke MCA.

A na-eji Metformin mee ihe na njikọ yana nri na usoro moto iji meziwanye nchịkwa glucose ọbara. A ga-eziga mmechi nke Kọmitii ahụ na European Commission, nke na-ekwupụta mkpebi ikpeazụ nke iwu maka mba ndị so na EU. "Sistemu arụ ọrụ na ahụ na-achịkwa SAS."

Kwadebere: Nevena Dzhulianova Angelova. Ana - na usoro metabolabol metabolism na ahụ dị n'okpuru ọnọdụ nkịtị bụ ezigbo nguzozi na proton na bicarbonate. Ihe si na urea putaputara n ’ikuku. Nke gara aga na-egosipụta ike nke metabolism metabolic, nke ikpeazụ na-emetụta mmebi nke sọlfọ nwere amino acid, phospho, nucleo - na glycoproteins. Mbubata nke ngwaahịa bara ụba na ihe ndị nwere nkụ na-eme ka mmepụta nke ndị NGO. Oge iwepu sel kewara oge, ọrụ nke gbanwere mmiri na ebughari mmiri.

CAdị MCA a dị ụkọ ma ọ bụ n'ihi nsonaazụ "mmejọ metabolic" dịka ụdị nke m glycogenosis (erughi glucose-6-phosphatase) na ụkọ hepatic fructose bisphosphatase. Formsdị MCA ndị a bụ congenital nwere ntụpọ na gluconeogenesis, pyruvate-dehydrogenase complex, okirikiri Krebs, na usoro iku ume cellular.

Ihe kachasị mkpa bụ sistemụ bicarbonate na haemoglobin. Oke nke ihe ndi mmadu na acho uzo ha bu ihe “enyo” maka profaịlụ acid na aru ya. A na - ejikọta usoro acidosis na alkalosis na usoro ndị na - akpata mgbanwe na mkpokọta hydrogen ion. Homeostasis nke ịta mmanụ ion dị na ahụ na-adabere n'ọtụtụ usoro, ihe kachasị mkpa bụ. Usoro ihe eji echekwa mmiri bụ ihe ngwọta nke acid na-adịghị ike na ntọala ya na ya kwekọrọ, nke na-enye azịza ahụ ike iji nọgide na-enwe pH ma ọ bụ gbanwee ya mgbe ị na-agbakwunye nchịkọta acid na ntọala iji gosipụta ike nke ihe ndozi.

Ebumnuche bụ isi nke ọgwụgwọ MCA bụ ịchọpụta ma dozie ihe kpatara mkpokọta lactic acid na ịgbagha mmetụta ọjọọ nke acidosis n'ahụ. Ọnụnọ nke MCA dị mkpa n'ụlọ ọgwụ na-egosi ajọ ọrịa tupu mgbe ahụ. Survivallanarị nke onye ọrịa na-adabere, nke mbụ, na njirimara oge nke ihe ndị na-akpata MCA na mkpochapu ya dị mma.

Usoro ntinye ihe na-edozi nguzozi nke pH bu bicarbonates, phosphates na protein. Bicarbonate bụ ihe dịkarịsịrị mkpa nke nwere oke na protein, yana oke na-enye aka na ọkwa intracellular acid-base.

Usoro bicarbonate bụ naanị ihe mere maka ịgbakọ steeti alkaline acid nke onye ọrịa na-anọchi anya nha anya. Otu usoro nchekwa ihe dị iche iche dị na ahụ nwere ike ichekwa ihe ma ọ bụ ike ha, gosipụtara n'ikike ụzọ ha. Ọbara bụ ihe ngwọta siri ike nke nwere ọnya mmiri abụọ, plasma na sel ọbara ọbara, nke membrane erythrocyte na-emetụta. Maka mmeghachi omume a, a ga-ewepụ ngwaahịa ahụ. Bicarbonate nwere ike ibute ọrịa ma ọ bụrụ na hypoxia anụ ahụ dị.

A na-ekpebi nkọwapụta ọgwụgwọ maka ihe kpatara ọrịa ahụ. Ọnọdụ ụzụ na hypoxia chọrọ mgbazi ngwa ngwa. Shụ na ikuku kwesịrị ekwesị bụ ihe ọ dị mkpa. Mweghachi nke ọbara mgbali, mmepụta obi na nsị anụ ahụ na ọbara oxygenated. A na-eji usoro ọgwụgwọ ọgwụ ọgwụ eme ihe site na iji mmiri ọbara, nnọchi plasma, ma ọ bụ ọbara (dịka egosipụtara). Eleghị anya, ị ga-ezere iji vasopressors, n'ihi na ha nwere ike belata nsị anụ ahụ na ịba ụba acidosis. A na - eji ọgwụ ndị nwere nkụpụta obi dị ala na ọgwụ ndị na - ebelata oke ibu. Catecholamines na-akwalite glycogenolysis ma nwee ike ịbawanye mmepụta lactic acid. Site na ụdị B MCA, ọrịa na-ebu ụzọ adịghị achọpụta ngwa ngwa ma ọ bụ wepu ya. Medications Tụ ọgwụ metụtara MCA ga-akwụsị, ọrịa ahụ chọrọ ọgwụgwọ oke.

Ọ bụrụ na hypoxia dị adị, ojiji nke bicarbonate nwere ike bụrụ ihe na - adịghị mma n'ihi ịba ụba nke mmepụta lactate na ikuku oxygen n'oge ị na - ebugharị akwara. Nke a pụtara na na lactic acidosis ma ọ bụ njide obi mgbe bicarbonate, ọgwụgwọ nwere ike ịdị ize ndụ. Enwere ike iji bicarbonate eme ihe n'ọtụtụ ikpe yana oke acid anisic acid. Lactic acidosis nwere ike ịka njọ mgbe ọ na-ede akwụkwọ bicarbonate. Ihe omumu ihe omumu egosiputala uru bicarbonate di na ketoacidosis di oria.

N'okwu ndị a, naanị ihe ịrịba ama nke iji bicarbonate bụ njikwa ihe mberede nke hyperkalemia siri ike. Njikwa kachasị mma nke metabolic acidosis bụ iji lebara ihe na-akpata ya anya ma were otu usoro ọgwụgwọ maka nsogbu niile nwere ike ịdapụta. Ngwakọta Organic acid na-arụ ọrụ dị ka ihe ndị na - ebido bicarbonate, megharia bicarbonate ọhụrụ ozugbo enwere ọgwụgwọ. Na mgbakwunye, usoro ọgwụgwọ bicarbonate nwere ike ibute alkaline diuresis, nke na-eme ka ntọhapụ nke kelilileal na ahawe ya ngwa ngwa.

Ndabere maka ọgwụgwọ nke acidosis na MCA bụ nchịkwa intravenous nke sodium bicarbonate (NaHCO 3). Ebumnuche nke ọgwụgwọ a bụ iwepu mmetụta ọjọọ nke acidosis ma nweta oge maka mmejuputa usoro nke iji dozie ihe kpatara acidosis. Ọ bụrụ na enwere ike iwepụ ihe kpatara MCA ngwa ngwa (dịka ọsịsọ iku ume ma ọ bụ ụkwara ume ọkụ), mgbe ahụ agaghị achọ ọgwụ ọgwụgwọ. Mmetụta ekwesighi nke acidosis gụnyere mgbochi nke myocardial contractility yana mbelata nke mmepụta cardiac na pH n'okpuru 7.1. Mgbe pH dara n'okpuru 7.0, arteriolar dilatation na hypotension nwere ike ime. Na mgbakwunye, na pH dị n'okpuru 7.0, ịba ọcha n'anya nke lactate na-emebi emebi na mmepụta ya site na imeju na akụrụ nwere ike ịmalite. Nke a nwere ike ibute ọrịa obi, nke na - ebukarị ụdị B MCA.

Usoro ọgwụgwọ bicarbonate nwere ike ịba uru n'ịhazi ọrịa na-efe efe n'ihi acidosis na-abụghị ndu. Na acidosis na-enweghị ndu, enweghị anion Organic nke enwere ike metabolized iji weghachi bicarbonate. Ozugbo edozila ihe kpatara ihe kpatara ya, mkpebi nke ihe otutu na - apụta ngwa ngwa ma ọ bụrụ na ejiri ọgwụ bicarbonate mee ihe. Onu ego ezubere iji dozie ọrịa a ga-achịrịrị. Ebumnuche bụ bulie pH gị ihe gbasara elu karịa 2, belata mmetụta ọjọọ nke acacia, wee zere mmetụta nke ọgwụ bicarbonate.

Dabere na ụfọdụ ndị na-ede akwụkwọ, iji ọgwụ agwọ ọrịa na MCA mgbe ụfọdụ ọ bụghị naanị na-eweta uru, mana ọ nwere ike imerụ ahụ. Echiche a dabere na data nnwale yana nyocha nke ịdị irè sodium bicarbonate na ọgwụgwọ nke DKA na mkpọnwụ akpịrịkpa (ọrịa obi na njide). Ajụjụ a, o doro anya, ọ ga-adịgide na ọdịnihu dị nso. Ruo mgbe a ga-ahụ ihe ọzọ dị mma ebe a, ojiji nke sodium bicarbonate ga-aga n'ihu yana ọgwụgwọ etiotropic.

Dịka iwu, etinyere sodium bicarbonate na pH 7.1 (ma ọ bụ ala). Ọ na - eji obere ego nke nwere ike iweghachi pic system dị na ọkwa nchekwa hemodynamically (dịka ọmụmaatụ, pH 7.2). Nleba anya nke onodu acid na-adi nkpa iji choputa ego nke bicarbonate. Ọtụtụ mmetụta adịghị mma nke ọgwụgwọ bicarbonate gụnyere mmiri mmiri na oke ibu sodium, hyperosmolarity, alkalization, ịba ụba mmepụta lactate, mgbanwe nke oxygenhemoglobin dissociation curve to the በግራ, na CSF paradoxical acidosis.

Enwere ike ịgbakọta ihe dị ka bicarbonate chọrọ iji dozie acidosis site na iji usoro ndị a:

Mpepu nke HCO 3 = (25 mEq / l HCO 3 - ọkwa nke HCO 3) x 0,5 (ịdị arọ na n'arọ).

Ejiri usoro a dabere na echiche nke na ekesa bicarbonate n'ime oghere ruru ogo 50% n'ime kilo kilogram. N'ezie, oghere nke bicarbonate na-abawanye na ọnọdụ nke hypobicarbonatemia, yabụ, iji 50% nke oke ahụ gbakọọ oghere a nwere ike ịkalata mkpa bicarbonate.

Iji dozie ọrịa nje na ụfọdụ ndị ọrịa, achọrọ sodium bicarbonate dị ukwuu. Enwere ike ịgwọ ndị ọrịa na-enweghị ike ịnabata ibu nke mmiri na sodium na infusion bicarbonate na ike loop diuretic ma ọ bụ Tris (hydroxymethyl) aminomethane. Enwere ike belata hyperosmolarity site na ịtinye ampoules 3-4 nke NaHCO, (44 mEq / L) na 1 lita nke ihe ndozi dextrose 5% nke mmiri. Ngwọta a na-enye 132-176 mEq / L, n'otu n'otu. Ojiji nke loop diuretics siri ike na-enye gị ohere ịmepụta oghere intravascular maka mmiri na sodium. Ejiri diuretic a na ọnụọgụ zuru ezu iji hụ na ngwa diuresis (300-500 ml / h). Enwere ike tufuo potassium na sodium n’ime mmamiri ma kwụọ ụgwọ maka mgbe ijuju mmiri na-aba n’ime mmamịrị.

Ndị ọrịa nwere oliguria chọrọ hemodialysis, nke na-enye ohere iwebata nnukwu sodium bicarbonate. Enwere ike iji bicarbonate dochie mmiri mmiri diolites ahụ, ebe nnu na sodium chloride wepụrụ site na azịza hypertonic nwere ike dochie ya site na nnu bicarbonate. A na-ewepụ Lactate site na hemodialysis na peritoneal dialysis. N'ihi enweghị ihe akaebe na ion ion na-emerụ onwe ha, usoro ọgwụgwọ a adịghị mkpa. Iwepu lactate, ka osila di, nwere ike belata ili achi, nke na - eme mgbe ekwenyechara acidosis.

Site na oge pH na-eme ka ọ dị ntakịrị ka ọ dị n'ọrịa lactate n'ime ọbara, ọtụtụ oge na-agafe (ọ na-abụkarị ọtụtụ awa). Cohen na-atụ aro iji ndidi chere oge a, na-ezere iji usoro ọgwụgwọ ndị ọzọ dị ize ndụ. Karịsịa, ọ na-atụ aro belata infusion nke bicarbonate ọtụtụ awa mgbe ọ gbasasịrị pH. Ọ bụrụ na pH amalite ịbelata, mgbe ahụ enwere ike ịba ụba ọnụego bicarbonate. Mgbe pH kwusiri ike na oke ịnabatacha, enwere ike ịkwụsị infusion. Dịka oge niile, ọnọdụ ụlọọgwụ nke onye ọrịa bụ ihe kachasị mma maka ịtụle usoro ọgwụgwọ.

Ọtụtụ ọgwụ ndị ọzọ ka akwadoro maka ọgwụgwọ MCA. N'ime ha bụ insulin, glucose, thiamine, methylene anụnụ anụnụ, vasodilators, dị ka sodium nitroprusside, yana nnwale nkwadebe dichloroacetate. Ọtụtụ ndị na-ede akwụkwọ anaghị atụ aro iji insulin ma ọ bụ ihe jikọtara ya na glucose na ọgwụgwọ MCA. Enwere ike gosipụta insulin maka ndị ọrịa mamịrị nwere MCA concomitant ma ọ bụ mmụba na-enweghị atụ na oghere acidotic anionic. Usoro ọgwụgwọ insulin na n'ọnọdụ ndị a kwesịrị ịdabere na mkpa onye ọrịa ahụ. Egosiputa glucose na ọnụnọ nke hypoglycemia na MCA ka ọ dozie lactic acidosis.

Thiamine bụ ihe nrụpụta dị mkpa maka enzyme nke na - ejikọ ọkwa nke mbụ na - eme oxidation. Edere vitamin a maka ndị aholicụrụma nwere lactic acidosis, mana edobeghi ọrụ nke thiamine na ọgwụgwọ nke ndị ọrịa ndị ọzọ. Methylene acha anụnụ anụnụ bụ redox dye nke nwere ike ịnabata ion hydrogen na, ya mere, iji NADH mee NADH ka ọ bụrụ Ndo +, nke na-egbochi ntụgharị nke pyruvate na lactate. Agbanyeghị, nnwale ụlọọgwụ akwadobeghị ịdị irè nke ọgwụ a. Usoro ọgwụgwọ Vasodilator sitere na echiche ahụ bụ na anụ ahụ na-eme ka nsị anụ ahụ dị mma na mbelata nguzogide akụkụ ahụ na mmụba na mmepụta obi. Ekwuputaghi na nti ndi vasodilal na ọgwụgwọ nke ICA.

Dichloroacetate (DHA) bụ ọgwụ nnwale na-eme ka ọrụ nke pyruvate dehydrogenase na-abawanye, nke na-atụnye ụzụ glucose, pyruvate na lactate ma, n'ihi ya, belata ọkwa lactate n'ime ọbara. Ebe ọ bụ na achọrọ oxygen maka usoro metabolic a, DHA anaghị arụ ọrụ ọ bụla na ọgwụgwọ nke ụdị M M.A ọrụ ya na ọgwụgwọ nke ụdị B MCA nwere oke n'ihi mmụba nke ketosis na nsogbu akwara ndị a hụrụ n'oge eji ya.

Eziokwu nke mgbalị iji ọtụtụ nhọrọ ọgwụgwọ nnwale maka MCA na-egosi nsonaazụ ọjọọ nke ọnọdụ a site na iji usoro ọgwụgwọ dị adị. Ọnụ ọgụgụ ndị ọrịa nwere ụdị A MCA dị ihe dị ka 80%, yana ụdị B, site na 50 ruo 80%. Mmata mbu na mmezi nke ọnọdụ dị n'okpuru ICA, n'ụzọ kachasị mma na-enye aka na mbenata ọnụ ọgụgụ ndị nwụrụ anwụ dị elu.

1. Nlekọta ahụike mberede: Trans. site na Bekee / N'okpuru H52 ed. J.E. N’oge, R.L. Crome, E. Ruiz. - M .: Medicine, 2001.

2. Ọrịa dị n'ime ahụ Eliseev, 1999

Acidosis sitere na mmụba nke mkpokọta hydrogen na ọbara nke akwara elu karịa ogo 40 nmol / L yana pH nke 7.4. Enwetara site na mkpokọ carbon dioxide, ngwaahịa metabolic nke ngwaahịa ma ọ bụ mbelata mkpokọta mmiri ọgwụ alkaline n'ime ọbara. Onye otu na-akọwa onsidemiya ọnọdụ pH dị ala, ebe acidosis bụ usoro na-eduga na ọnọdụ a. Ọkwa nke arụ ọrụ cellular cellular na-emetụta ma n'otu oge ahụ pH nke mmiri ahụ. N'ime anụ ahụ, pH nkịtị nke ọbara akwara na - agbanwe site na 7:35 ruo 7:50 dabere na ụdị. N'ime ahụike, ụkpụrụ ndị a bụ 7.35 - 7.45 7.8. Ọnọdụ PH dị na mmadụ na ndụ kwekọrọ na 6.8 na. Mgbanwe na pH nke ọbara akwara (na mmiri ọzọ na - emezi ya) na mpụga nke a na - eduga mmebi sel na - agbanwe agbanwe.

Dabere na usoro nke acidosis, a na-ekewa ya na metabolic, akụkụ iku ume yana agwakọta, yana dabere na ụkpụrụ pH - akwụghachi ụgwọ ma mebie.

Acidosis nke okpo iku ume

Acidosis respiratory acidosis n'ihi mmụba nke mkpokọta carbon dioxide n'ime ọbara (hypercapnia) n'ihi hyperventilation. Ọ na - ebutekarị ngụgụ, isi ọwụwa, ị medicationụ ọgwụ (ọgwụ na ị sedụ ọgwụ). Pneumothorax, emphysema, bronchitis na-adịghị ala ala, ụkwara ume ọkụ, oyi baa na-akpata. Ọnọdụ ahụ nwere ike ịbụ mmeghachi mmeghachi omume na alkalosis metabolic na-adịghị ala ala.

Lactic acidosis

Typedị metabolic acidosis na-emetụta njikọ nke lactic acid (lactate) na anụ ahụ (na hypoxia anụ ahụ, ụfọdụ ọgwụ, wdg) .. Lactic acidosis na-eme mgbe mkpụrụ ndụ mepụtara lactic acid ngwa ngwa karịa ahụ na-adọta ya. Ihe mgbaàmà nke lactic acidosis bụ iku ume miri emi na ngwa ngwa, ọgbụgbọ na mgbu afọ. Lactic acidosis nwere ike ime n'ihi ọtụtụ ebumnuche. Ihe a bu ihe di nkpa na oria shuga. Lactic acidosis bụ mmeghachi omume na-adịghị ahụkebe ma ọ bụ nke siri ike na-eme mgbe ị nwusịrị Metformin (Glyukofag), ọgwụ maka ịgwọ ụdị ọrịa shuga II.

Metabolic acidosis

Nke a bụ mmụba nke mkpokọta hydrogen na mbelata nke mkpokọta bicarbonate na mmiri anụ ahụ, n'ihi nchịkọta nke acid na ntọala, mmụba nke ihe na-aba n'ahụ ahụ. Nke a nwere ike ime maka afọ ọsịsa, ọrịa akụrụ na ndị ọzọ. Ejiri metabolabol acidosis bụ mmụba na mmepụta nke metabolic acid, dịka iwu, n'ihi ọgba aghara na usoro nke mwepu ha site na akụrụ. Renal acidosis metụtara mkpo urea na creatinine, yana nsị metabolic acid sitere na protein metabolism.

Mmụba na-abawanye nke acid ndị ọzọ nwekwara ike ịkpata metabolic acidosis. Iji maa atụ, lactic acidosis nwere ike ịbụ ihe abụọ kpatara ntiwapụ:

Acidosis - acidification nke ahu

1 Acidosis - acidification nke ahu
- 1.1 Ihe mgbaàmà nke acidosis - kedu ka acidation nke anụ ahụ si egosipụta onwe ya?
- 1.2 Kedu ihe ọghọm nke acidosis?
- 1.3 Ebumnuche nke acidation nke anụ ahụ: gịnị kpatara acidosis ji eme?
- 1.4 Ndepụta nke ngwaahịa nke nwere ike ichebe megide acidosis - ngwaahịa ndị nwere ikike
- 1.5 aciddị acidosis
- Nchoputa 1.6os nke acidosis
2 Etu esi ewelata acidity n’ahụ - ọgwụgwọ acidosis

A na - akpọ Acidosis na nkà mmụta ọgwụ n'ọnọdụ ụfọdụ nke ahụ na - enwe mgbanwe doro anya na nguzogide acid na - ebute acidity ya.

N'okwu a, enwere ike ịkọ acidity na ihe zuru oke na oke ikwu acid.

Na mgbakwunye na nke a, na-enwe ụba acid nke anụ ahụ, a na-enwe mmụba mgbe niile na mkpokọta hydrogen ion.

Acidosis bụ ọrịa oge niile.

Ọ dị oke njọ ịtụle na ụdị ahụ ahụ (ọ na - eme kwa oge na ọbụna nke a na - atụle "n'usoro iwu") bụ ihe dị mma maka ndụ ọhụụ, ọ dị anya na ọbụbụenyi na nchekwa gburugburu ya.

Shouldkwesighi iwepu onwe gi na nsogbu nke nsogbu dị na ahụ gị, ọ bụ ihe amamihe karịa ịtụgharị n'ihe omuma, ghọta ihe kpatara acidation nke ahụ ma mee ihe niile ị nwere ike ime ka ọdịmma gị ka mma.

Na ngwa ngwa ị ga-emezi okwu a, ọ ka mma, yabụ nsogbu ebilitewo dị mfe ma dozie ya na mmalite - kachasị mma maka mkpebi ọsọsọ ma na-aga nke ọma.

Ihe mgbaàmà nke acidosis - kedu ka acidation nke anụ ahụ si egosipụta onwe ya?

Ngosipụta nke akuko nke acidosis (ihe mgbaàmà) siri ike iche na mgbaàmà nke ọrịa ndị ọzọ.

Nnukwu “nkọcha” nke ọrịa a bụ na n'ụdị acidosis dị nro, ngosipụta ụlọ ọgwụ a na-adịkarị ala na-emebi mmebi nke ọkwa acid.

Ihe mgbaàmà nke acidosis bụ ngosipụta ndị dị ka:

vomiting
obi palpitations
ọnwụ nke mmụọ
ọbara mgbali elu
ujo ala
obere ọgbụgba
obi arrhythmias,
iro ụra
izugbe oria
anya ntughari
ndaba,
ịhapụ echiche.

Ọ dị mkpa ịmara na n'ụfọdụ (yana ọkachasị n'ụdị dị nwayọ), acidosis nwere ike ịbụ asymptomatic!

Kedụ ihe egwu dị na acidosis?

Acidosis dị ize ndụ - ọ bụ eziokwu a na-apụghị ịgbagha agbagha.

Ọ bụrụ na ịnweghị isi n'okwu a n'oge, mgbe ahụ ị ga-eche nsogbu ndị ka njọ.

Ebe ọ bụ na mmebi a na - apụta n'ihi nsonaazụ (nnabata) nke ngwaahịa nke sọks nke acid, nke dị na ọnọdụ a na - ekpochapụ ngwa ngwa site na ahụ mmadụ, ụdị mmebi ahụ, ọ bụrụ na i wereghị ihe dị mkpa n’oge iji gbanwee ọnọdụ ahụ, nwere ike ibute ya.

ịba ụba n'ọbara
obi ọgụ nke akwara obara,
akwara mkpụrụ osisi,
Coma
akpịrị ịkpọ nkụ (akpịrị ịkpọ nkụ)
infarction myocardial
nnukwu mbibi ụbụrụ
ajọ nsogbu n’iru sisitemu,
mgbanwe ndị dị egwu na ọbara ọgbụgba,
na ọnwu.

Ọ bụ ya mere ihe mbụ dị mkpa iji kpochapụ acidosis nke anụ ahụ bụ ịchọpụta ihe kpatara ọrịa a.

Ihe kpatara acidification nke aru: gini kpatara acidosis ji eme?

E nwere ọtụtụ ihe na-akpalite uto nke acidosis, na ha niile dị ezigbo mkpa ma dị njọ:

nsị anụ ahụ (nri na kemịkal),
mmebi nke ngba,
nri riri
tụụrụ ime
akpịrị ịkpọ nkụ
na-emesi ike na-aga n'ihu,
nsogbu nke metabolic (metabolic),
hypoglycemia (idebe ala nke Sasar n'ọbara),
ise siga
ị regularụ mmanya mgbe niile
oxygen na-ezughi oke oke ọbara (nke a na-akpọ agụụ oxygen),
nnukwu akwara ọdịda
arụ ọrụ akụkụ akụkụ iku ume,
ịkpa ọjọọ neoplasms ke idem,
Oriri na-ezighi ezi, na-adịghị mma (gụnyere nri ndị adịghị mma na nri ndị dị mkpa maka ahụ),
ihe ufodu ogwu (karie - iji ogwu eme ihe ogologo oge),
Ọnọdụ gburugburu ebe obibi ọjọọ.

N'ọnọdụ ndị a na-adịghị ahụkebe, acidosis nwere ike ịmalite dịka ekwenyeghị “n'enweghị ihe doro anya” na-egosi mmalite nke ọnọdụ a.

Dabere na ọnụ ọgụgụ, otu n'ime ihe ndị na-akpata acid acid na-adịghị ala ala nke anụ ahụ taa bụ nri na-adịghị mma, nke na-adịghị mma, nri nke enwere ọtụtụ ọ bụghị naanị ndị ọbịa maka ahụ, kamakwa akụkụ ndị na-emebi ihe n'ụzọ doro anya.

Yabụ, ọ nweghị nri dị mma nwere ike ịdabere na otu ihe kpatara "nsị nke anụ ahụ."

Ọ dị mkpa! Na nwute, nri mmadụ nke oge a bu pụta ụwa na ahaghị nzi nke hydrogen ion na bicarbonate. Nke a amaghị aha na -ebi ndụ obere metabolic acidosis. Nke a pụtara na mmadụ na-ebi ndụ nwa oge, maka ndụ ya n'ọnọdụ enweghị ike ịkpọ Ahụike ...

Banyere okwu banyere nri, ọ dị mkpa ịmara nke ọma ụdị nri ndị na-eduga n'ịdị acidation nke anụ ahụ, nke, n'ụzọ megidere, na-eso akpata ya, ya bụ, na-amụ ndepụta nke nri "acidic" na "alkaline", ma na-edozi nri gị mgbe niile n'ụzọ ziri ezi. .

Ndepụta nke Ngwaahịa Pụrụ Chebe Megide Acidosis - Alkalisation Ngwaahịa

Ọ bụ ihe nwute na, nri nke nwoke nke oge a nwere ike ịbụ nke a na-akpọ alkalizing.

N'ụzọ bụ isi, nri kwa ụbọchị na-ejupụta na acidic kama nri alkaline, nke a bụ kpọmkwem ihe kpatara ma ọ bụrụ na ọ bụ acidosis dị umengwụ, ma ọ bụ ọnọdụ dị nkọ, nke n'ọtụtụ ọnọdụ na-akpalite atherosclerosis ma ọ bụ ọbara mgbali elu, ma ọ bụ ọrịa shuga, nkụchi obi, wdg, ma ọ bụ ugbua, cha cha, enweghị nkwekọ na ndụ…

Nri oriri nke nwoke nke oge a tumadi nwere abụba juru eju, shuga dị mfe, nnu okpokoro.

Ka osila dị, ọ dị ezigbo njọ na eriri keesi, potassium na magnesium. Ọzọkwa, na nri nke ihe ka n'ọnụ ọgụgụ, enwere ọtụtụ nri a nụchara anụcha ma hazie ya, ngwaahịa ntụ ọka, shuga, yana ọtụtụ ụdị ngwaahịa ndị ọkara emechara.

Nri dị otú ahụ nwere vaịn acidic, ihe ndị a niile na - emetụta nnọọ usoro biochemical dị na ahụ, na - emebi, na - akụghasị, na - akụ ọrụ ọ bụla nkịtị, ma mkpụrụ ndụ niile yana akụkụ ahụ niile na sistem!

Ọrịa na-adịghị ala ala, nke na-enye nsogbu oge niile na-akpalitekwa akpukpọ acidosis. A mụwo ọtụtụ narị ọmụmụ otu esi agbanwe ike acidity ọbara na nrụgide mberede na-eduga na acid acid: ntụle acid-base na-agbanwe ozugbo!

Ndụ ibi ndụ, ezughi oke ikuku dị mma: ụbọchị ole na ole ụdị ndụ a zuru oke maka ọnọdụ mmadụ imebi nke ukwuu.

Ọ bụ ihe nwute, ọtụtụ n'ime anyị bi na steeti a ruo ọtụtụ afọ, na-emezi ka ahụ anyị si ele, nke ahụ bụ:

ala ịhapụ
enweghị mmasị
Obi erughị ala
ọjọọ ọrụ nke ngwara,
akpukpo aru (akpụkpọ ahu),
ihe jọrọ njọ, na ala mara mma,
akpụkpọ anụ ndị na-adọ aka ná ntị
isi awọ
mkpa 'iwulite' onwe gị ike n'ụdị tii na kọfị,
na ndị ọzọ ... ọ dị nwute na-abụ "ụkpụrụ" ...

Emere nnwale gosipụtara mmetụta dị ike na sistem acidation nke ahụ ụlọ, ekwentị, mbadamba na ngwa ndị ọzọ dị mkpa maka mmadụ ọgbara ọhụrụ.

Mmiri ọ drinkingụ drinkingụ na-adịghị mma, gụnyere mmiri site na karama plastik na gas mmadụ, bụ otu n'ime ihe ndị mere acidite nke anụ ahụ na-ezughị iji mmiri dị ọcha.

Ihe dị iche iche metụtara gburugburu ebe obibi nke enwere ike ịkpọ "enweghị ihe ịga nke ọma" - nke a bụ ezigbo nsogbu n'ụwa nke ugbu a, nke nwere nnukwu mmetụta na ahụike mmadụ, na-enweghị ịgbanwee na ntụpọ acid-base nkịtị nke ahụ mmadụ.

Ọzọkwa, nyochaa ndepụta nke ihe kpatara acidosis ma rụọ ọrụ iji kpochapụ ha. Maka arụmọrụ ka ukwuu, ịkwesịrị ịchọ enyemaka n'aka ndị ọkachamara.

Acdị Acidosis

Otutu acidity di nma - 7.25 - 7.44.

Beyondga karịa oke (7.45) na nke kacha nta (7,24) ụkpụrụ na-eduga mgbe niile ịrụ ọrụ enzyme, mbibi mkpụrụ ndụ, inye onyinye protein, nke, n'aka nke ya, na-abụkarị ihe kpatara ọnwụ nke anụ ahụ.

Ọdịiche dị n'etiti acidosis kwụrụ ụgwọ na ngụkọ.

A na - eji acidosis akwụ ụgwọ iji acidity ọbara, nke na - agbadata na njedebe dị ala.

Ọ bụrụ na agbanyere uru nke ihe ngosi ahụ n'akụkụ akụkụ acidic, mgbe ahụ, a na-ewere acidosis na-enweghị mkpokọta.

Mgbanwe ahụ nwere ike ime n'ihi oke acid, yana n'ihi enweghị usoro physico-chemical na usoro ọmụmụ nke na-edozi nguzozi acid.

Acos gbara ụgwọ na-emerụ ahụ ahụ mgbe niile na enweghị ike ruo ọtụtụ ọnwa ma ọ bụ ọbụna ọtụtụ afọ, na-eji nwayọọ nwayọọ na-eduga na ọnwụ nke anụ ahụ.

Acidosis sitere na ya nwere ike ịbụ gas (iku ume), ọ bụghị gas, yana agwakọta.

Gas acidosis na-abụkarị n'ihi enweghị mkpụcha carbon dioxide n'ahụ ma ọ bụ ikuku ikuku ma ọ bụ ikuku, nke nwere ụba carbon dioxide.

A na - amata acidosis na - abụghị gas, yana oke nke ụfọdụ acid ndị na - agbanwe agbanwe, yana mbelata nke ihe bicarbonate n'ime ọbara.

Maindị ụdị nke gas abụghị acidosis bụ:

excretory
metabolic
acidosis na-efe efe.

Metaboldị metabolic nke acidosis, dịka iwu, na-ebilite n'ihi oke, mkpebi ma ọ bụ ejikọtara ngwaahịa acidic na anụ ahụ. Yabụ, ụdị ọrịa a nwere ike ịmalite ketoacidosis na lactic acidosis.

Ketoacidosis bụ ọnọdụ sitere na mmụba nke ọdịnaya plasma nke anụ ahụ ketone, nke na-amalite:

ọrịa shuga
nri carbohydrate,
oké insulin hypoglycemia,
nnukwu aru ogu
mmanya na-egbu egbu,
hypoxia
na-agba ọkụ
mmerụ ahụ
ya na ụfọdụ ụdị ahu izizi.
Lactic acidosis bụ ọrịa na-enweghị nsogbu nke na-etolite n'ụfọdụ ọrịa pathologies siri ike. Nke a na - emepụta ihe ị ga - eme maka ịhazi na mkpokọta lactic acid n'ime ọbara.

Lactic acidosis nwere ike ime nwa oge na ọrụ ọrụ na-abawanye ụba, ọkachasị ma ọ bụrụ na emeghị ya, ndị na-adịghị njikere na-enwe mgbatị ahụ dị otú a: n'oge usoro a, mmepụta nke lactic acid na-abawanye, na n'ihi enweghị oxygen, acid a adịghị abụkarị oxidized.

Lactic acidosis agbatịwo ogologo oge nwere ike ime na:

nnukwu mmebi imeju,
na -ebelata inye ahụ oxygen dị mkpa anụ ahụ,
imebi ezi ọrụ nke ọrụ gbasara ahụ.

Banyere ọgwụ acid a na-akpọ excretory acidosis, a na-amata mbelata nke ikuku na - agbanwe agbanwe nke ahụ mmadụ.

A na-ahụkarị ụdị a nke acidosis na ọrịa akụrụ, nke na-eme ka o sie ike iwepu phosphates acid na Organic.

Acidosis nwere ike ime n'ihi mmụba nke sodium ion na mmamịrị. Usoro a nwere ike ime, dịka ọmụmaatụ, iji ọgwụ sulfa na-adị ogologo oge, yana ụfọdụ ọgwụ mkpị.

Na mgbakwunye, acidosis mmiri a na-akpọ excretory nwere ike ime n'ihi mmụba nke ogige dị mkpa site na mgbaze nri (afọ ọsịsa, vomiting, salivation ogologo oge, wdg).

Acidosis na-ekpo oke na-abụkarị mgbe etinyere ụba nke acidic ogige, nke nwere ike ịbụ ọgwụ ike, n'ime ahụ mmadụ.

Banyere ụdị acidosis agwakọtara, a na-ahụkarị ụdị ọrịa a na ndị nwere ọrịa obi ma ọ bụ ndị nwere akụkụ iku ume.

Acosisis zuru oke na-ewerekarị ọnọdụ na enweghị mgbaàmà ọ bụla. Enwere ike ịchọpụta ya naanị site na inyocha usoro ntinye ọbara na nsonaazụ nyocha nke mmamịrị.

Ọ bụrụ na acidosis malitere imemiwanye, mgbe ahụ, otu n'ime ihe mgbaàmà mbụ bụ mmeghachi omume pathologies site na sistem iku ume, mkpọchi dị nkọ, wdg.

N'ihe banyere acidosis na-ejikọghị ọnụ, enwere ike ịhụ mmebi nke na-arụ ọrụ nke sistemụ akwara dị n'etiti, nke dịka ọmụmaatụ, dị ka ụra, ọgbụgba, enweghị mmụọ, na nsogbu nke ọrụ autonomic.

Ihe dị mkpa! Metabolism acidosis na-etolitekarị na ibu ogologo oge, depatensus diabetes nke ọrịa obi, ujo ụjọ, imeju imeju, iko urea, ubara acid na shuga na ụmụaka.

Ihe ịrịba ama nke metabolic acidosis gụnyere nsogbu dị iche iche nke ọrụ na ịmara onye ọrịa. Nke kachasị, onye na-arịa ọrịa nwere ụra ụra, ike ọgwụgwụ na mgbaàmà niile nke enweghị mmasị.

Site na ụkọ insulin, a na-achọpụta mgbochi ụdọ akwara, yana mbelata ụda olu.

Banyere gas acidosis, ọ na-amalitekarị site na ịmịkọrọ ọnụ nke akpa ume, nke na-egosipụtakarị onwe ya na mgbanwe nke ọdịdị nke onye ọrịa.

Dịka ọmụmaatụ, agba nke anụ ahụ na-agbanwe, ma ọ bụ na ihu na-acha odo odo wee na-eme ọsụsọ. N'otu oge ahụ, ọnọdụ uche onye ọrịa ahụ na-agbanwekwa: na mbụ, akuko na agwa okwu na-apụta.

Site na oganihu n'ihu nke oria, ura, oria na - aputa ihe, nke n’eji nwayọ ghuba mmetuta nke miri emi.

N'okwu a, nkeji nkeji iku ume, dịka iwu, jiri nwayọ belata.

Ọ bụrụ na arrhythmia nke akụkụ okuku ume pụtara, nke a na - egosi oke mgbochi nke akụkụ okuku ume, yana mbelata oghere nke akụkụ iku ume na carbon dioxide.

Ọzọkwa, ọdịnaya oxygen na ọbara na-aga n'ihu ma na-enwe agụụ oxygen, nke na-eduga na metabolic acidosis. N'okwu a, mmadụ nwere mmụba n'ọnụego obi, akwara arrhythmia pụtara.

Ọ bụrụ na amaliteghị ọgwụgwọ n'oge, mgbe ahụ akpịrị nke acidotic coma, nke na-ejedebe na ọnwụ, nwere ike ịtụwa onye ọrịa.

Ihe dị mkpa! Njirimara nke ọrịa obi na akwara na-enyocha acidosis, na-adaberekarị na nsogbu elektrolyte concomitant. A na-ebelata ọbara mgbali elu na mmepụta obi. Site na akpịrị ịkpọ nkụ, ụkọ sodium na ọbara ọgbụgba, mbibi nwere ike ịda.

Ọtụtụ mgbe, ndị ọrịa na-abawanye na ọnụego obi, yana nsogbu ọgba aghara dị iche iche, mana na-abawanye ụba nke potassium na ọbara ọbara, ọnụego obi nwere ike, ọzọ, ibelata. Olu mepụtara

mmamịrị ahụ na - ekewa na - ebuwanye ntakịrị, mana iji acidosis akpọrọ akpọrọ, nke a na - ejikọkarị yana nrụgide, mbelata ego mmamịrị na - ekewa.

Site na iji acidosis, oburu na enweghi mmamiri banye eriri afo ga-ekwe omume.

Ọ bụrụ na pH ada n'okpuru 6.8, mgbe ahụ a na-ahụta uru a ekwekọghị na ndụ.

Ọrịa Acidosis

Iji gosipụta nchoputa ziri ezi, nyochara ọbara na mmamịrị dị iche iche nke dọkịta. Nnyocha ọbara nwekwara ike ikpebi ụdị acidosis.

N'ọnọdụ ụfọdụ, enwere ike ịkọwa nyocha ndị ọzọ iji chọpụta ihe kpatara acidosis.

Maka nchoputa nke acidosis (ma, ya mere, maka nyocha nke oma na ogwugwo NKWUKWU EGO) A na-achọ nnwale ụlọ nyocha ọ bụla, nke dọkịta ga-edenye gị!

Ọ bụrụ na ntụpọ acid-achọpụtara site na nyocha ụlọ nyocha erughị 7.35, nke a bụ ihe akaebe nke ọnụnọ nke usoro acidosis na-agbagha, n'ọnọdụ nke onye ọrịa ahụ ka a na-aga ụlọ ọgwụ ngwa ngwa.

Acidosis Na-akpata

A na-ewere Acidosis taa ka ọwapụta n’ụwa niile. Mana maka arụ ọrụ anyị, ọ dị mkpa iji lekọta gburugburu ya yana acidity zuru oke. Ebe ọ bụ na acidity nkịtị bụ uru pH nwere ihe ngosipụta nke 7.35-7.45, acidosis bụ ọnọdụ pathologies nke acidity belata n'okpuru pH 7.35.

Ihe ndị mere acidation nke anụ ahụ ji arụ ọrụ ụfọdụ bụ, dịka ebe mmetọ, ụdị ibi ndụ nke enwere ntakịrị mmegharị na, n’ezie, nri na-adịghị mma. Ihe ndị a niile na-eme ka ndụ adịghị mma n'ụdị isi ọwụwa na ike ọgwụgwụ.

Ọ bụ ihe nwute, mmadụ ọgbara ọhụrụ na-eri taa ngwaahịa dị otua nke na - eduga n'ịbe acidosis n'ime ya. Na mgbakwunye, ọ bụ mmejọ iche na nri acidic na-akpata acidification ma ọ bụ acidosis n'ime ahụ. Na mkpokọta, acid bụ ihe na-esite na usoro metabolic dị n'ahụ ahụ n'oge mmebi na nhazi nke ngwaahịa nri nwere abụba, hydrocarbons, phosphat, amino acid nwere sọlfọ.N'ihi nkewapụ ihe ndị a niile, etolite acid nke sitere na osisi, nke enwere ike ịpụ ya site na njikọta nke akwụkwọ nri na mkpụrụ osisi na - abanye n'ime ahụ, yana n'ihi ihe ndị alkaline mepụtara n'ihi metabolism.

Iji mee ka acid na alkaline ghara imezi ihe, a chọrọ usoro ndị na-egbochi ọbara, yana akpa ume na akụrụ. Site n'enyemaka nke ngụgụ, akwara na-agbanwe site n'ahụ ahụ, akụrụ na-adịghị agbanwe agbanwe. Na mgbakwunye, nri mmadụ, ọnọdụ uche ya na ọbụna oge ụbọchị nwere ike imetụta acidity nke akụkụ ahụ. Dịka iwu, a na-eji ọkara nke abụọ nke mkpụrụ ọgwụ acidic banye mmamịrị, enwere ike kpebie na ọnụọgụ otu pasent site na enyemaka nke nnwale litmus. Na 99% nke asịd na-abụba mmamịrị na oke nwere oke. Urinekpụrụ pH na-ahụkarị pH kwekọrọ na ụkpụrụ sitere na 6.2 ruo 6.9. Ọ bụrụ na -ebelata ụkpụrụ ndị a site na 4.5 ruo 6.0, nke a na-egosi na ngwaahịa dị ukwuu na-abanye n'ahụ ahụ nke na-ebute etolite asịd n'ime ahụ.

Na mgbakwunye, ajọ ọrịa na-efe efe nke ngụgụ, akụrụ, ma ọ bụ nsogbu izugbe nke metabolic nwere ike ibute acidosis. Ma ọtụtụ ụdị nke ọrịa na-adịghị ala ala nwere ike ibute acidosis latent, nke ga-enwe mmetụta na-adịghị mma maka ahụ ogologo oge. E nwekwara ọtụtụ ọrịa na-akpata ọrịa pathologies nke ọrịa rheumatic, neoplasms ọjọọ, caries, mmeghachi omume nfụkasị ahụ, ọnya anụ ahụ nke ọdịdị ala na-adịghị ala ala na neurosis.

Ọrịa Acidosis

Ihe fọrọ nke nta ka ọ bụrụ ihe ịrịba ama na ngosipụta nke acidosis n'ụzọ dị nro ma ọ bụ agafeghị oke metụtara ọrịa na-akpata ya. Ma akara ngosipụta nke ọrịa a na-egosi na ọnụnọ acid dị n'ọbara.

Dịka iwu, a na-ezochi ihe ịrịba ama nke acidosis n'okpuru akara nke isi ọrịa yana o siri ike ikewa ha. Dịka ọmụmaatụ, ụdị acidosis dị nwayọ fọrọ nke nta ka ọ bụrụ asymptomatic ma ọ bụ mgbe ụfọdụ ike ọgwụgwụ, ọgbụgbọ na ọgbụgbọ na-ahụ. Ma na metabolic acid metabolis siri ike, hyperpnea na-egosipụta onwe ya, nke mbụ e ji amata iku ume, na emesịa ugboro ugboro (syndrome Kussmaul). N'ọnọdụ ụfọdụ, enwere akara nke mbelata ECG, mbelata alkali site na eriri afọ. Na mgbakwunye, acidosis siri ike na-eduga n'ọzụ nke akpata ụjọ n'ihi oke obi obi na mmeghachi omume akwara na mpụta, na catecholamines, na-emekwa ka ọ bụrụ ihe ịtụnanya.

A na-egosipụta mgbaàmà nke acidosis megide nzụlite nke ụgwọ zuru oke nke iku ume iku ume na ọnụnọ adịghị ike nke acid n'ime ọbara (acidemia) kama adịghị ike karịa na metabolic na iku ume acidosis na njikọta. N'okwu a, sistemụ ime ahụ na-ama jijiji mgbe pH nke ọbara erughị 7.2. Ihe ize ndụ nke arrhythmias na-abawanye ụba na usoro ọrịa obi ọfụma ma ọ bụ nsogbu ndị ọzọ metabolism. N'ihi acididemia, mmeghachi omume nke akwara ọbara na obi nye catecholamine na-ebelata, nke a na-ebute mbelata ọbara mgbali n'ihu hypovolemia ma ọ bụ ujo.

Site na acidosis, a na-eme ka iku ume kawanyewanye, mgbochi insulin na-amalite, protein na-eme ngwa ngwa, yana mgbochi nke ATP na-egbochi. Site n'ụdị ọnọdụ a dị njọ, usoro metabolic dị na ụbụrụ na-agbagha, nke na-akpata iro ụra na coma mgbe niile.

A na - egosipụta akpati ozu nke metabolic acidosis site na afọ ọsịsa ma ọ bụ ezughi oke inye ọbara na anụ ahụ. A na-ahụkarị nke a site na lactic acidosis, nke dị mfe nchọpụta site na nyocha anụ ahụ. Ọkpụkpụ ọbara na-ebelata gụnyere akpịrị akpọnwụ, oke ọbara, ujo, ma ọ bụ ọrịa obi. Ihe mgbaàmà nke metabolic acidosis na-adịghị ala ala n’ime nwatakịrị, tinyere ọrụ ezumike ezughi ezu, nwere ike ịbụ mmepe ngwa ngwa. Otito nke polyuria na-egosiputa ọnụnọ nke ọrịa ketoacidosis na-arịa ọrịa shuga na ọrịa mellitus na-enweghị nchọpụta. A na - egosipụta ọnya ọrịa na - emetụta ihe mmadụ na - ahụ maka ịwa ahụ site na nkwarụ ma ọ bụ igbochi ọdịdị mmadụ niile.

A na-ahụ Hepatomegaly nke metabolic acidosis megide mmalite nke mmebi imeju, nkwarụ obi, enwetara.

Ihe mgbaàmà ụlọ nyocha nwere mgbanwe nke electrolytes, glucose, nitrogen urea n'ime ọbara, na mmamịrị.

Starnwụ nri na-adịghị mma ma ọ bụ nke na-adịghị mma, ketosis na eriri afọ na-eto. Na mgbakwunye, na ọdịda akụrụngwa, a na-agbakọta oge dị elu na nkịtị anionic.

Acidosis na alkalosis

Imirikiti usoro ọgwụgwọ na - eme ahụ mmadụ nwere ike imetụta nguzozi nke acid na ntọala na gburugburu ya, na - akpata acidosis (acidification) na alkalosis (alkalization).

Site na acidosis kwụrụ ụgwọ na alkalosis, mgbanwe na oke carbonic acid na sodium bicarbonate na-apụta, mana nha ha na-abụ ihe nkịtị 1:20.

Acidosis na alkalosis nke ihe ndị mebiri emebi bụ ọnọdụ ndị mgbanwe na-eme ọ bụghị naanị na ngụkọta nke acid na alkalis, kamakwa na ngbanwe nke oke ndị a ma ọ bụ na acid ma ọ bụ n'akụkụ.

Ihe ịrịba ama nke nsogbu iku ume, n'adịghị ka nsogbu nke iku ume, bụ erughị ala nke carbon dioxide na ngafe nke ntọala.

Aciddị acidosis na - ebuteghị ume na - etolite n'ahụ mmadụ n'ihi nchịkọta nke ngwaahịa dị iche iche nke metabolic na - emebeghị. Ndị a gụnyere lactic acid, acetoacetic na hydroxybutyric. Otutu aru nke ketone na - eme mgbe glycogen di ala n’ime imeju n’ihi oke oke abụba, na - emegide ihe ụnwụ oxygen, na - agbagha usoro tricarboxylic acid. Na mgbakwunye, ọnọdụ pathologies dị iche iche na-enye aka na mmụba nke mkpo ahụ ketone ọtụtụ oge, ọ bụ ezie na akụrụ buru ibu na-amịpụta n'ụdị sodium na potassium salts. Nke a na - abụ nsonazụ nke ọnwụ nke nnukwu alkalis na mmepe nke acidosis decompensated.

Aciddị nke acidosis na-adị mkpụmkpụ n'ihi nsị anụ ahụ dị ukwuu n'ihi etolite lactic acid. Enwere ike igosipụta nke a na ọrịa obi na ngụgụ na-akpata ụkọ oxygen. Ma site na akụkụ akụrụ nwere nsogbu, amamịghe, phosphates, metabolic acidosis ma ọ bụ ọgwụ nwere ike etolite. Dịka iwu, ọtụtụ ọrịa gbasara akụrụ na-eso syndromes yiri.

Site na ọrịa afọ ọsịsa, alkali na-efu efu na-esochi, mmepe nke acidosis metabolic, ma ọ bụ ihe ọ alụkalụ nke alkaline na-ahapụ site na enterostomy. N'ihi acidosis a, a na-etinye usoro nkwụghachi ụgwọ na-anwale ịgbalị acid na alkaline homeostasis.

Iji kwụọ ụgwọ maka mgbanwe na pH nke ọbara na-eme ahụ, ntinye ngwa ngwa banye na ọrụ nke na-etinye aka na mkpokọta acid na ihe ndị dị na mpụga sel ahụ. N'otu oge ahụ, ha na-emekọrịta na alkalis nke sistemu sistemụ sel na ihe ọ beyondụ liquụ karịrị ha. N'ihi ya, alkalal na-ebelata, acidosis na-abawanye.

A na-ewere Hyperkalemia bụ ihe ịrịba ama dị mkpa nke acidosis. A na-ekesa oke nke maịlị hydrogen na ọkpụkpụ, ebe a gbanwere ha maka mkpọtụ akụkụ nke ọkpụkpụ ahụ. Nke sochirinụ, sodium na calcium na-abanye n’ọbara n’ọkpụkpụ, ya mere, megide nzụlite acidosis siri ike na-adị ogologo oge, a na-ahụ nro, n’onwe ya ịkpụlata ọkpụkpụ. Nke a na - eme ka ịta cations nke calcium, sodium na potassium na plasma ọbara.

Na mgbakwunye, metabolic acidosis bụ ihe eji mara acidicis na ntinye nke nnukwu acid na mbelata carbon dioxide. Agbanyeghị, sistemụ carbonate dị ike na-enyere aka belata ike carbonic si acid. Ọ dịghị nkwụsi ike na mmiri na carbon dioxide na-esite na ya ngwa ngwa. Ya mere, sistem-ọbara na-amalite ịrụ ọrụ. N'ihi ya, iku ume na-atọ ụtọ, hyperventilation na-amalite na ngụgụ, a na-ahapụkwa ikuku carbon dioxide dị ukwuu n'ọbara ruo mgbe a ga-eweghachi nguzozi n'etiti carbonic acid na sodium bicarbonate. N'otu oge, hyperchloremia na hypernatremia na-adịgide.

N'ihe banyere ịkwụsị ikuku nkuume, a na-achọpụta nsụba carbon dioxide n'ime ahụ, mgbe ahụ acidosis bụ ụdị agbaghari.

Akụrụ na usoro ịkwụ ụgwọ maka acidosis na-arụ ọrụ dị mkpa, ebe ọ bụ na e guzobere obere bicarbonate ma kee ya n'ime ndị ahụ, ndị gabigara site na mkpochasị ahụ na-enwetaghachi nyocha. Ma n'otu oge ahụ, acidity dị na mmamịrị ahụ na-abawanye n'ihi ọdịnaya dị mkpa nke acid nke titratable n'ime ya. Otutu n’ime ha bụ ahihia Organic.

Acidosis na alkalosis nwere ike ibute nsogbu dị iche iche. E gosipụtara nke a site na ụdị iku ume oge, mbelata nke olu vaskụla, imebi ikike ihe ndina vaskụla n’ihe metụtara ọbara mgbali, na mbelata nke mmepụta obi na ọbara ọgbụgba. N’ihi nke a, mgbasa ọbara akụrụ na-agbadata, usoro a na-agbacha ma na-emegharị ahụ. Dịka iwu, ọnọdụ ndị a na - akpata ọrịa na - akpata mgbanwe na ọrụ mmiri na nhazi mmiri elektrọn.

N'ihi usoro ogologo oge nke acidosis na alkalosis, ọkpụkpụ na-adị nro, na -ebido usoro ịkọ nkọ. N'otu oge ahụ, ọnụọgụ potassium na-ebelata na akwara anụ ahụ nke myocardium, ọdịnaya cation na plasma na-abawanye. Usoro ndị a niile na-abụ ihe na-akpata mmepe nke ọrịa pathologies. N'ihi ya, myocardium na-azụlite uche na-ezighi ezi na adrenaline, nke nwere ike ibute fibrillation. Ọzọkwa, a na-ehizi usoro dị iche iche nke arrhythmias, ndị na-egosi ECG na-agbanwe, ma na-ebelata ọrụ dị njọ nke akwara obi. Ma mmebi nke nguzozi nke electrolytes na-eduga na mgbochi nke excitability nke irighiri akwara na akwara. Na mgbakwunye, ịba ụba osmotic nke mmiri na-abụghị sel sel na-eduga ná nsụ anụ ahụ na akpọnwụ akpịrị.

Site na gas acidosis, carbon dioxide na-agbakọta n'ime ọbara n'ihi oke ikuku, akwara umeji, oyi baa, hypoventilation, craniocerebral trauma, ọbara mgbali intracranial, ọbara ọgbụgba, na oke carbon dioxide na gburugburu ebe mmadụ ahụ nọ.

Acidosis nke Lactic

Nke a bụ ọnọdụ a na - ebute ọnụnọ nke lactic acid na-agbakọta n'ime ọbara. Lactic acidosis bu ihe akuko abuo: udiri (A) na udiri (B). Typedị nke mbụ, anoxia anụ ahụ pụtara ìhè na-apụta, na ụdị (B) anaghị ahụ ihe ngosi ndị a.

A na-ahụta ụdị njiri D-lactic acidosis na ndị nwere anatomical ma ọ bụ ịrụ ọrụ nke obere eriri afọ. Na-emegide nzụlite mmepụta enzymes site na nje, a na-emepụta lactic acid, nke na-ebute mmụba nke acidosis metụtara oghere nke anions, yana coma ma ọ bụ nzuzu. N'otu oge, lactate na-adịgide.

Ldị Lactic acidosis (A) juru ebe niile karịa ndị ọzọ, n'ihi ụdị ujo dị iche iche. Ndabere nke pathogenesis nke lactic acidosis bụ ihe na-akpata anụ ahụ, anoxia na-esote ya na mkpokọta hydrogen na lactate ion. Ọnụego imeju imeju site na lactate na-ebelata n'ihi eziokwu ahụ bụ na mmanụ na-esi ísì ụtọ na celiac artery na hepatic artery na-ebelata, ischemia nke hepatocellular malitekwara. Na pH dị ala ma ọ bụ na uru nke 7.0, akụrụ na umeji nwere ike imepụta lactate. Ọgwụgwọ onye ọrịa nwere lactic acidosis mejupụtara ihe na-akpata nkụja, ebe ọ bụ na enwere mmekọrịta chiri anya n'etiti lactate ọbara dị elu na ọnwụ.

Na mgbakwunye, nnukwu hypoxia na nnukwu ike nwere ike ime ka e guzobe lactic acidosis nke ụdị a, nke na-eme ya na asphyxiation, edere edema, ọnọdụ asthmatic, nkwupụta nke ọrịa ngụgụ na-adịghị ala ala na nchụpụ site na carboxyhemoglobin, methemoglobin, hemoglobin oxygen.

Lactic acidosis ụdị (B) na-etolite na mberede, n'etiti otu oge. Ihe ndi n’enwe ike ibute oganihu oria a anaghi aghota nke oma. A na-eche na usoro nke lactic acidosis nke ụdị a na-emetụta site na usoro nke mpaghara subclinical mebiri emebi anụ ahụ. Ọtụtụ mgbe, ụdị ọnọdụ a siri ike na-eduga n'ọbara, nke na-eme ka o sie ike ịchọpụta ma dị iche na ụdị (A). Na mgbakwunye, ụdị (B) lactic acidosis bụ nke ejiri ụdị atọ dị iche iche mara.

N'okwu nke mbụ, ụdị acidosis a na - apụta n'ihi ọrịa shuga, akụrụ na ọrịa imeju, ọrịa, ọnọdụ nkwarụ, na neoplasia. Ọgba aghara nke imeju yana lactic acidosis na-eduga na nnukwu necrosis na cirrhosis. Ọzọkwa ọtụtụ mgbe, ọdịda akwara na-adịkarị njọ na ụdị na-adịghị ala ala na-esonyere acidosis a, ọ bụ ezie na ọ nweghị mmekọrịta causal dị n'etiti ha. Na mgbakwunye, bacteremia, leukemia, ọrịa Hodgkin, lymphoma nke juputara, myeloma, ọrịa akwụkwụ nwere ike ịkpalite omume nke lactic acidosis.

Ejiri ụdị toxins, ọgwụ ahụhụ na ọgwụ n'ihi ihe ekpughere mara ụdị nke abụọ. N'okwu a, lactate dị n’ọbara na-abawanye nke ọma.

Thirddị nke atọ nke lactic acidosis dị ụkọ, ọ bụkwa glycogenosis nke ụdị mbụ na ụkọ nke bisphosphatase hepatic fructose.

Ihe na-akpata lactic acidosis

Ọtụtụ mgbe, lactic acidosis na-etolite ụdị ọrịa shuga mellitus nke 2 na ndị ọrịa, bụ ndị megidere nzụlite nke ọrịa na-akpata ọrịa, na-arịa infarction ma ọ bụ ọrịa strok.

Isi ihe kpatara aka na mmepe nke lactic acidosis n’ime ahụ bụ ndị a:

oxygen anụ ahụ nke anụ ahụ na akụkụ ahụ,
mmepe nke anaemia,
ọbara ọgbụgba na-eduga n'ọbara dị ukwuu,
nnukwu mmebi imeju
ọnụnọ nke ọdịda akụrụ, etolite mgbe ị na-ewere metformin, ọ bụrụ na enwere akara izizi sitere na ndepụta edepụtara,
mgbasi ike dị elu na oke arụ n'ahụ,
ihe mberede ma ọ bụ sepsis,
njide obi
ọnụnọ n'ahụ ahụ nke ọrịa shuga na-achịkwaghị achịkwa ma ọ bụrụ na a drugụrụ ọgwụ hypoglycemic nke ọrịa mamịrị,
ọnụnọ ụfọdụ ọrịa shuga na ahụ.

Enwere ike ịchọpụta ihe omume nke pathology na ahụike n'ihi nsonaazụ ahụ mmadụ nke ụfọdụ ọnọdụ yana ndị ọrịa nwere ọrịa mellitus.

Ọtụtụ mgbe, mmiri ara ehi acidosis na-ebute ndị ọrịa mamịrị na-emegide usoro ọrịa shuga na-achịkwaghị achịkwa.

Maka ọrịa mamịrị, ọnọdụ ahụ a dị oke njọ ma dịkwa njọ, ebe ọ bụ na n'ọnọdụ a, lactacidic coma nwere ike ịmalite.

Lactic acid coma nwere ike ibute ọnwụ.