Enwere ike ịtụle ọnọdụ ndị a dị ka ihe ndị na-enye aka na mmepe nke lactic acidosis:

Ọrịa na-efe efe.
Nnukwu ọbara ọgbụgba.
Nnukwu myocardial infarction.
Mmanya na-egbu egbu na mmanya ndị ọzọ.
Mgbalị siri ike.
Ọrịa imeju na-adịghị ala ala.
Odida ntaramahụhụ.

Ebe pụrụ iche n'etiti ihe etiological na-ewere biguanides. Ekwesiri ime ka ọ pụta ìhè na na mmebi nke imeju ma ọ bụ akụrụ, ọbụna ntakịrị nke biguanides nwere ike ibute lactic acidosis n'ihi nchịkọta ọgwụ na ahụ.

Pathogenesis edit |

Lactic acidosis

Lactic acidosis (lactic acidosis, lactacidemia, hyperlactatacidemia, lactic acidosis) bụ ọnọdụ nke lactic acid na-abanye n'ọbara ngwa ngwa karịa ka ewepụrụ ya, nke nwere ike ibute mmepe nke nsogbu ndụ. N'ime ihe karịrị 50% nke ikpe, edebara aha acid lais n'ime ndị ọrịa nwere ọrịa mellitus.

Na nzụlite nke lactic acidosis, akụkụ ụbụrụ ya na akụkụ akwara ya na-adịgide, coma na-adịgide, na ọnwụ nwere ike ịmalite.

Lactic acid bụ ngwaahịa ikpeazụ anaerobic glycogenolysis na glycolysis, mkpụrụ nke gluconeogenesis, bụ ihe eji arụ ọrụ site na akwara obi. Mmụba nke ọdịnaya nke lactic acid dị n'ọbara bụ n'ụzọ bụ́ isi ya na inwe ụba ya na akwara ya na mbelata ike nke imeju iji gbanwee lactic acid ka ọ bụrụ glucose na glycogen. N'ihe banyere ọrịa deellensation nke ọrịa shuga, ọkwa nke lactic acid dị n'ọbara nwekwara ike ịba ụba n'ihi igbochi catabolism nke pyruvic acid na mmụba na NAD-N / NAD. Ntinye ọbara nke lactic acid nwere ike ime dị ka nyocha ọzọ.

Ihe Ndị Na-akpata Esemokwu

Hypoxia nke na-eme na akwara nke akwara n'ihi nrụgide anụ ahụ na-adịte aka nwere ike iduga mmepe nke lactic acidosis. Ọzọkwa, usoro a na - efe efe nwere ike ịmalite ọrịa mellitus nke ọrịa shuga, ọrịa neoplasms na-efe efe, ọrịa na-efe efe, ọdịda akụkụ, infarction myocardial, nnukwu ọrịa nke eriri afọ ma ọ bụ akpa ume, akụrụ gbasara akwara, ọrịa imeju na-adịghị ala ala, nnukwu ọbara ọgbụgba, mmerụ ahụ siri ike, mmanya na-adịghị ala ala.

Ihe ndị nwere ọghọm gụnyere:

ọrịa metabolic ọrịa,
Ọnọdụ immunodeficiency
ujo
Akwụkwụ na-adọ
ị certainụ ọgwụ ụfọdụ (dịka ọmụmaatụ, biguanides, ọkachasị mgbe ọnya na akụrụ)
erughi vitamin nke anụ ahụ (ọkachasị vitamin B)₁),
nsị carbon monoxide,
nsị na cyanide,
ihe methanol ma ọ bụ ethylene glycol,
ochichi parenteral nke fructose na onunu ogwu.

Site na lactic acidosis, achọrọ ụlọ ọgwụ ngwa ngwa iji dozie acidosis na hypoxia.

Lactic acidosis

Adị A (ejikọtara ya na hypoxia anụ ahụ)

Bdị B (anaghị ejikọ ya na hypoxia anụ ahụ)

Cardiogenic, endotoxic, ujo hypovolemic

Ọrịa metabolic arịa (ụdị 1 glycogenosis, methyl malonic acidia)

Oria ahu na (ma obu) imeju akwara

Nchịkwa nke ọbara nri nke ahịhịa dị elu nke fructose

Methanol ma ọ bụ ethylene glycol

Oria di iche

ọgụ megide hypoxia,
ọgwụ insulin.

Ọrịa shuga ụdị 2 bụ ọrịa na-adịghị ala ala nke gosipụtara site na mmebi nke metabolism metabolism na mmepe nke hyperglycemia n'ihi nguzogide insulin na nsị nke mkpụrụ ndụ β-sel, yana metabolism lipid na mmepe nke atherosclerosis.

SD-1 bụ ọrịa akpọnwụ akpọnwụ nke na-eduga ná mbibi nke mkpụrụ ndụ let sel nke islet, nke na-egosipụta oke ụkọ insulin. N'ụfọdụ, ndị ọrịa na-arịa ọrịa shuga mellitus-1 enweghị akara nke ọrịa autoimmune mebiri emebi β-sel (ọrịa idiopathic-1).

Mgbaàmà nke Lactic Acidosis

Lactic acidosis, dịka iwu, na-amalite nnukwu, n'ime awa ole na ole, na-enweghị akara ọ bụla. Ndị ọrịa na-eme mkpesa banyere mgbu olu, mgbu n'azụ sternum, dyspepsia, enweghị mmasị, ụra ma ọ bụ ehighị ụra, iku ume ngwa ngwa. Ọnọdụ ọnọdụ onye ọrịa na-aka njọ ngwa ngwa, mmụba nke acidosis na-esonyere mgbu na afọ na ọgbụgbọ, nsogbu akwara ozi (areflexia, hyperkinesis, paresis).

N'ọnọdụ siri ike, mgbaàmà a na-ahụkarị nke lactic acidosis bụ ngosipụta nke ọdịda obi, akwara acidosis na-eme ka usoro ahụ ka ọ na-aga n'ihu. Ọnwụ nke mmụọ na mmepe nke akpịrị na-aga tupu ịda mba, ọdịdị onye ọrịa na-eku ume ume (ụda ume na-anụ ebe dị anya), ọ nweghịkwa isi acetone na ikuku ekuru. Onye ọrịa ahụ na-etolite ọdịda, buru ụzọ jiri oligoanuria, emesia ya na ọrịa anuria, yana agbasa disagulation intravascular coagulation (DIC) sochiri. N'ebe ụfọdụ ndị ọrịa, ọbara ọgbụgba dị mkpịsị aka nke elu na nke ala ka amaara n'etiti akara nke lactic acidosis.

Atụmatụ nke lactic acidosis na ụmụaka

A na-egosipụta ụdị ketara eketa nke lactic acidosis na ụmụaka na-enwe nnukwu acidosis, yana nnukwu nsogbu iku ume. Ndị ọrịa nwere nkwonkwo akwara olu, oge igbu mmadụ n'ọmụmụ psychomotor. Ọtụtụ mgbe, ọnọdụ onye ọrịa na-akawanye mma site na afọ, mana n'ọnọdụ ụfọdụ usoro nchọpụta ahụ na-eduga n'ọnwụ.

Ihe dị ka 50% nke ọrịa lactic acidosis na-akọ na ndị ọrịa nwere ọrịa shuga.

Diagnostics

Ọ bụrụ na echere lactic acidosis, a na-atụle ihe ngosipụta ụlọ ọgwụ dịka akụkụ inyeaka. A ga-enyo enyo acidosis n'ụdị metabolic acidosis, nke jikọtara ya na mmụba anionic. Na lactic acidosis, ogo nke ọdịiche anionic nwere ike ịdị iche, mana ọ bụchaghị nkịtị. Mgbe enyochachara ọbara maka ọmụmụ kemịkalị, ọ kwesịrị ka agbanye ya ozugbo ka ọ bụrụ okpomoku 0 ruo + 4 Celsius C iji gbochie ịmepụta mkpụrụ ndụ lactic acid site na mkpụrụ ndụ ọbara uhie na vitro. Iji kwado nchoputa a, a na-ekpebi ikpehe lactic acid n'ime ọbara onye ọrịa. N'okwu a, mkpebi nke ọ bụghị naanị aka ekpe - kamakwa deomrorotatory isomer nke lactic acid nwere uru nchọpụta dị mkpa. Na mgbakwunye, na lactic acidosis, a na-achọpụta mbelata ọdịnaya nke bicarbonates n'ime ọbara na hyperglycemia na-agafeghị oke. Acetonuria nọ n'ọnọdụ a abụghị.

A na-eme nchọpụta ọdịiche dị iche iche nke lactic acidosis na hypoglycemia nke usoro dị iche iche (gụnyere glycogenosis), encephalopathy.

Site na lactic acidosis, achọrọ ụlọ ọgwụ ngwa ngwa iji dozie acidosis na hypoxia.

Nlekọta ihe mberede na-etinye ọsụsọ nke 2.5 ma ọ bụ 4% sodium bicarbonate ngwọta ruo 2 lita kwa ụbọchị. N'okwu a, a ga-enyocha ọkwa nke pH ọbara na ịta ụta nke potassium. Ọ bụrụ na ọ dị mkpa, a na-eme ọgwụ insulin, a na-enye ọgwụ na-eji dochie ọgwụ mgbochi ujo ka ukwuu iji mee ka hemodynamics, plasma ọbara na heparin dị ala iji dozie hemostasis. A na - ewepụ Hypoxia site na iji ọgwụgwọ oxygen; enwere ike ịchọ ikuku ikuku. N'ihe banyere lactic acidosis mgbe ị na-ewere biguanides, ịba ọcha n'anya nwere ike ịdị mkpa.

A na-egosipụta ụdị ketara eketa nke lactic acidosis na ụmụaka na-enwe nnukwu acidosis, yana nnukwu nsogbu iku ume.

Nsogbu na nsonaazụ nwere ike ime

Na nzụlite nke lactic acidosis, akụkụ ụbụrụ ya na akụkụ akwara ya na-adịgide, coma na-adịgide, na ọnwụ nwere ike ịmalite.

Nnọọ nke ụdị ae nwetara na lactic acidosis na-adabere n'ọrịa na-akpata ọrịa nke o bilitere, n'ogo nke lactic acid dị n'ọbara onye ọrịa, yana n'oge etu esi etinyere ọgwụgwọ ya. Site na mmepe nke nsogbu, yana ụdị ịmụ nwa na lactic acidosis, prognosis na-akawanye njọ.

Mgbochi

Iji gbochie mmepe nke lactic acidosis, a na-atụ aro ya:

n'oge ọgwụgwọ nke ọrịa nke lactic acidosis nwere ike ime (isi ụgwọ maka ọrịa shuga na mgbochi nke hypoxia), na-agbaso ndụmọdụ niile nke dibịa gaa,
Zere ị drugsụ ọgwụ ọjọọ
mụbaa ọgụ
ịhapụ omume ọjọọ,
ezere nrụgide anụ ahụ na nke uche.

Na akara mbụ nke lactic acidosis, ị kwesịrị ịchọrọ enyemaka ahụike ozugbo.

Aro maka iji ọgwụ eme ihe

Drugsfọdụ ọgwụ hypoglycemic nwekwara ike ibute nsogbu, dịka ọmụmaatụ, ị medicationsụ ọgwụ maka oria na ọrịa catarrhal n'otu oge.

Ọkpụkpụ ndị na-agbawa agbaze nwere ike ịbụ ihe mbụ kpatara lactic acidosis.

A na-enwekarị ikpe mgbe ọgwụ ọgwụ na biguanides, n'ihe banyere akụrụ gbasara ọdịda, abụrụla ihe na-eme ka a nwee lactic acidosis. Nchịkọta ọgwụ na ahụ na - aru nwere ike inye aka na nke a.

Ọ bụrụ na ọrịa mamịrị chefuru ị aboutụ ọgwụ, mgbe ahụ ịkwesighi ịkwụ ụgwọ maka nke a ma were ọtụtụ mbadamba otu oge. Exgafe oke ọgwụ ahụ nwere ike ibute nsonaazụ oke n'ahụ.

Mgbaàmà nke Ọrịa shuga

Ọtụtụ mgbe, ọ dịghị ihe na-egosipụta ọdịdị nke lactic acidosis. Agbanyeghị, n'oge dị mkpirikpi, n'ime awa ole na ole, ihe mgbaàmà nke oria na-apụta. Ihe izizi gunyere: mgbu n’ime akwara na n’azụ sternum, ọnọdụ enweghị mmasị, iro ụra (ura), iku ume ngwa ngwa.

Ntị! Ọzọkwa, isi ihe na-akpata lactic acidosis na-amalite - enweghi ike nke obi, na-agbagwoju anya site na ịba ụba acidity. N'ịga n'ihu, n'ọrịa nke pathology, afọ mgbu na-egosi, ya na ọgbụgbọ, ọgbụgbọ

Ọ bụrụ na ịnaghị usoro dị mkpa maka ọgwụgwọ, ọnọdụ onye ọrịa ahụ ka njọ.

Mmeghari nwa oge. Mmadu ekwenyeghi na eziokwu gbara ya gburugburu, ma ghazie ikwusi ya. Onye ọrịa ahụ nwere nkwarụ akwara ụkwụ, ihe na -eme arụ, ọrụ moto na-ebelata.

Site na inwekwu mmepe nke lactic acidosis, Coma na-apụta. Ihe akwara ya bụ ọdịdị nke iku ume nwa oge na enweghị mmachi na-esochi ya.

Ọgwụgwọ ọnọdụ

Site na ọrịa shuga a dị ize ndụ, ọ dị mkpa ka dọkịta gwọọ ya ngwa ngwa. Mgbe etinyere ya na ulo ogwu, ogwu ya di na sodium bicarbonate. N'okwu a, a na-eme nyocha mgbe niile maka ọkwa potassium na ọbara.

Edere onye ọrịa na-arịa ọrịa shuga ọgwụ injection ọzọ. Ọ bụrụ na ọ dị mkpa, a na-agbanwe ọgwụ ya kwa ụbọchị, ma ọ bụ dochie ọgwụ a na-eji dochie ya. N'ime ọgwụgwọ ahụ, a na-eji mmiri carbonxylase eme ihe, nke a na-enye ntapu, na ntinye. Dị ka dọkịta si kwuo, iwebata plasma ọbara dị mfe. A na-agwọ Heparin (na obere doses).

Klọ ọgwụ ndị na-ewu ewu

Maka nsonaazụ nke ọgwụgwọ dị mgbagwoju anya, a ga-anabata iji ọgwụ herbal. Nwere ike igosipụta nri ụfọdụ nke ọgwụ ọdịnala:

Osisi a na-eme ka ego nke lactate dị. Brewed ma drunkụọ mmanya kama tii. Mgbe ahụ, ị ga-ezere iri ihe dị ka otu awa.

Ọ na-eweghachi metabolism zuru oke. Osisi ahụ na-enye gị ohere kechie acid lactic, nke na-apụta n'ụzọ nkịtị.

Icho mma. 250 ml nke akụrụngwa na-awụpụ ya na mmiri esi. A na-enye ihe ọ drinkụ drinkụ ọ resultingụ drinkụ na-aba n'anya ma na-ewere ya na 100 ml ugboro abụọ n'ụbọchị.
Tincture. A na-agwakọta ihe ọkụkụ ahụ na glycerin na oke nke 1: 4. A ghaghị inye ngwakọta a maka ụbọchị 21. A na-ewere ya na ngaji ugboro abụọ n'ụbọchị.
Mmanya Ntọala bụ mmanya siri ike (ọbara ọbara). Na mmanya 500 ml, a na-agbakwunye otu tablespoon nke osisi. Ọnwụ ruo ọnwa dịkarịa ala. Tupu ị lakpuo ụra, were otu ngaji.

Mkpụrụ ndị a na -ebelata nguzozi acid ma weghachite ngha. Osisi jupụtara na mmiri ọkụ na-enye ihe dị ka otu awa. A Theụcharị ngwakọta ahụ kpamkpam na-enweghị wepụ flaxseed. A na-eme usoro ahụ na afọ efu.

Ọgwụ niile dị irè, mana tupu iji ha, ịkwesịrị ịgakwuru onye na-ahụ maka ọgwụ endocrinologist.

A na - amata ụdị nsogbu ndị a dị ka usoro mmepe acidosis:

Acidosis na-abụghị akụkụ okuku ume,
Acidosis ume iku ume (inhalation nke ikuku nwere oke ikuku carbon dioxide),
Aciddị acidosis agwakọtara (ọnọdụ kpatara ụdị acidosis dị iche iche).

Acidosis na-abụghị okuku ume nọ n'okpuru aka nkewa ndị a:

Acidosis Excretory - ọnọdụ na - ebilite mgbe enwere mmebi nke ọrụ iwepu acid na ahụ (arụ ọrụ ezigharị ọrụ)
Metabolic acidosis bụ ọnọdụ kachasị mgbagwoju anya nke ejiri ngụgụ nke acid endogenous na anụ ahụ nke anụ ahụ,
Acidosis na-ebu ibu bụ ọnọdụ nke ịba ụba ịta acid n'ihi ntopute nke ọtụtụ ihe ndị a gbanwere ghọọ acid n'oge metabolism.

Dika ọkwa pH, a na - eke acidosis dika:

Kwụrụ ụgwọ
Ihe gbara ọkpụrụkpụ
Na-agbagha.

Mgbe pH ruru kacha nta (7.24) na oke (7.45) ụkpụrụ (pH nkịtị 7,7 - 7.44), kọlịflawa, mbibi mkpụrụ ndụ, na ọnwụ nke arụ ọrụ enzyme na - eme, nke nwere ike ibute ọnwụ nke anụ ahụ.

Lactic acidosis nwere ike ịmalite site na iji ọgwụgwọ na-adịghị mma nke ọrịa shuga site na iji ọgwụ biguanide. Ọdịda dị ukwuu na glucose yana ọdịda akụrụ na-eduga na mkpọchi, oke lactic acid, ịxụ ahụ.

Maka igbochi lactic acidosis, ị ga-emerịrị biguanides kpam kpam dịka ntuziaka ahụ si dị, mezie ọgwụ ahụ dọkịta nyere gị, hapụ mgbanwe nnwere onwe na-eme kwa ụbọchị. Mgbe ị na-ede ọgwụ, ịkwesịrị ime nyocha nke ọma gbasara akụkụ niile na sistem iji wezuga ọrịa ọjọọ nke usoro urinary. Na ọnụnọ nke ọdịda akụrụ, ọ dị mkpa ịhọrọ ọgwụ nke otu ọzọ iji jikwaa ọkwa glucose.

Gbalia imata shuga obara ugboro asaa n’ime ubochi iji mata ihe odi n’otu n’oge. Ohere nke lactic acidosis na-abawanye na ọgwụgwọ ọrịa shuga na-adịghị mma, enweghị nlebara anya kwa ụbọchị nke ọkwa glucose. Emebi iwu nke usoro ọgwụgwọ, ịhapụ iji mita ahụ, ịgbaso nri nwere ike ibute shuga shuga, mmepe nke hypoglycemia.

Na mgbakwunye na ịhapụ usoro ọzọ nke ọgwụ hypoglycemic, ị gaghị enwe mbadamba mbadamba abụọ oge ọzọ kama ịgụta otu: hypoglycemia nwere ike ịmalite,
site na mmepe nke ọrịa nje ma ọ bụ nje, ị kwesịrị ịkpọtụrụ dọkịta gị ozugbo maka ọgwụgwọ zuru oke. Ọ bụghị mgbe niile ka enwere ike ịkọ ihe mmeghachi omume nke anụ ahụ na - adịghị ike na ọrịa na - emetụta pancreas na ọgwụ nje ma ọ bụ ọgwụ mgbochi. N'oge usoro ọgwụgwọ, ịchọrọ izu ụra, njikwa dọkịta iji chọpụta nsogbu nke lactic acidosis na usoro ndị ọzọ na-adịghị mma.

Site na usoro ọmụmụ nke endocrine pathology na mgbaàmà dị nro, ị nwere ike ịpụ nzụlite nke nnukwu nsogbu. Dọkịta na-agwa ndị mmadụ ka ha na-amụkwu gbasara ya ma ọ bụrụ na ndị ikwu okenye achọpụtala ọrịa shuga

Ọ dị mkpa ịmata etu lactic acidosis si amalite n'ụdị ọrịa shuga nke ọrịa shuga nke 2, olee ihe ndị na-akpalite nsogbu dị ize ndụ.

Ọrịa shuga, lactic acidosis na-amalite n’otu ntabi anya. Ọnọdụ mmalite dị nro na obere elekere ole na ole nwere ike banye n'ụdị siri ike yana mgbaàmà ọria. Mụta otu esi egbochi nsogbu ndị dị ize ndụ na vidiyo na-esonụ:

Ọrịa nrịanrịa na-abụkarị nnukwu ọrịa maka lactatacidemia enwetara, onyonye ahụike zuru oke na-ekpughe n'ime awa 6-18. Oria ọghọm ẹre ọ ghaa khin. N’agba nke mbụ, a na - egosipụta acidosis n’onweghị nke ọma: ndị ọrịa na - ahụta adịghị ike, enweghị ọmịiko, akwara na obi mgbu, mgbakasị ahụ n’ụdị ọgbụgbọ, oche tọgbọ, na mgbu afọ. Agba nke etiti na-esokwa mmụba nke lactate, na-emegide nzụlite nke enwere hyperventilation nke ngụgụ. Ọrụ gas nke akpa ume anaghị arụ ọrụ, carbon dioxide na-agbakọ na sistem. Mgbanwe na iku ume ọrụ ana akpọ Kussmaul iku ume. A na-ahụ usoro ọzọ nke usoro ụda mmiri na-adịghị ahụkebe nke nwere ume miri emi na oke ume ọwụwa.

Achọpụtara ihe mgbaàmà nke obi na-adịghị ala ala na akwara. N'ime ndị ọrịa, ọbara mgbali na-ebelata nke ukwuu, hypotension na-abawanye oge niile, nwere ike ibute daa. Imepụta ure na-akwụsịlata, oliguria amalite, mgbe ahụ, nsogbu ahụ. Egosiputa ihe di iche iche nke akwara ozi akwara ozi - areflexia, spastic paresis, hyperkinesis. Anxietybawanye ụjọ moto, delirium. Na njedebe nke etiti etiti, DIC na-eme. A na-achọpụtakarị thrombosis nke ọrịa ọnya ọgbụgba ọbara. Na ngwụcha ikpeazụ, a na-eji nzuzu na coma dochie anya mkpagide psychomotor. A machibidoro ọrụ nke ụjọ ahụ, akwara obi, akụkụ iku ume na urinary.

Site na ụdị B lactic acidosis, ihe mgbaàmà na-apụtakarị na ụbọchị mbụ nke ndụ nwatakịrị. Ọgba ume iku ume na-abịa n'ihu: dyspnea - ura ume, mmetụta nke ikuku, polypnoea - iku ume elu ngwa ngwa, ọnọdụ dịka ụkwara ume ọkụ - ụkwara na-a coughụ, uzu, na-esiri iku ume ma na. N'etiti mgbaàmà akwara ozi, hypotension muscle, areflexia, cramps dịpụrụ adịpụ, akụkụ nke amamịghe siri ike. Onweghi obi uto na aru, olu mgbe nile, olu nke ime, aru aru, olu nke aru. N’ọdịnihu, na-egbu oge mmepe uche na ahụ ike.

Iwu izugbe na usoro ọgwụgwọ

Site na mmepe nke nsogbu dị iche iche nke ọrịa shuga 2, ọ dị mkpa nlekọta ahụike ngwa ngwa. Ọ bụghị mgbe niile ka enwere ike ịkọ amụma uto nke ọrịa shuga siri ike. Ndụ onye ọrịa na-adabere na ịmara nke ndị ikwu nọ nso na mmalite nke ihe ịrịba ama nke lactic acidosis na iru eru nke ndị dọkịta na-enyere aka.

Nke mbu, ikwesiri ikpochapu hypoxia na acidosis, kwusi usoro ihe eji enyere ndu aka

Ọ dị mkpa iji wepu onye ọrịa ahụ na ọnọdụ ujo, iji mepụta ikuku na ngụgụ. Ọ bụrụ na ndị ọrịa mamịrị amaghị ama, yabụ ịchọrọ ịba ngwa ngwa maka ikuku oxygen iji banye n’ime sel ahụ

Ndị dọkịta na-ewepụ oke acidity nke ọbara, wepụ mmetụta na-adịghị mma nke oke lactic acid na ngwọta nke sodium bicarbonate. A na-eme usoro kwa ụbọchị ruo mgbe njigharị nke ihe ndị kacha egosi na ahụ ga-eme. N'otu ụbọchị, onye ọrịa anaghị enweta ihe karịrị lita abụọ nke alkaline.

Ọzọkwa, insulin na-eme nwa oge na glucose, cardiotonics na vasotonics ka enyere n'iwu ka ọ hazie ọrụ nke obi na usoro akwara. N'oge usoro ọgwụgwọ, a chọrọ nyocha ọbara iji nyochaa mkpokọta potassium na pH ọbara.

Muta maka igbochi oria shuga n’ime umuaka na ndi okenye, ma guo ntuziaka na-enye aka nke ndi okacha mara.

Edere iwu na atụmatụ nke nri maka hypothyroidism nke gland thyroid na edemede a.

Gaa na http://vse-o-gormonah.com/hormones/testosteron/kak-ponizit-u-zhenshin.html ma gụọ ihe na-akpata mmụba testosterone na ụmụ nwanyị, yana otu esi agbadata ọkwa hormone dị ka ọ dị. .

Nzọụkwụ ọzọ bụ usoro ọgwụgwọ ọcha:

nchịkwa intraven nke carboxylase,
mgbazi nke ọgwụ insulin,
mmeghe nke ọbara plasma,
Edebere obere usoro heparin iji kpochapụ DIC
mmeghe nke reopoliglyukin.

Mgbe nkwusioru, nhazi nke ihe ịrịba ama dị mkpa, onye ọrịa nọ n'ụlọ ọgwụ. Gbalịa ịgbaso usoro nri, na-ejikwa ịdị omimi nke mgbanye glucose na acidity ọbara, tụọ ọbara mgbali elu

Mgbe ị laghachitere, ị ga-agbaso nhọpụta nke endocrinologist, were ọgwụ hypoglycemic jiri nlezianya mee ihe, na-eji nke ọdịnala ahụ.

Hyperlactacidemia na ndị ọrịa mamịrị na-etolite na ezughi oke oxygen. Yabụ, na mbụ, n'ụlọ ọgwụ, ọ dị mkpa iji edozi oxygen (anụ ahụ) oxygen ka o kwere mee. A na-eme nke a site na iji ventilashị. Ndị dọkịta kwesịrị iwepụ mmepe hypoxia ozugbo enwere ike.

A na-enyocha ihe ngosipụta niile dị mkpa n'otu oge.

A na-elebara ndị agadi anya na-arịa ọbara mgbali.

Ọ bụrụ na enyocha hyperlactatemia site na nyocha, ọkwa pH erughị 7.0, mgbe ahụ onye ọrịa ahụ malitere itinye sodium bicarbonate intravenously. A na-edozi mmiri ahụ site na mmiri na-enweghị atụ, sodium bicarbonate, ihe ha na potassium chloride. Tinye ya na mpekere akara ruo awa 2. Ole ihe ngwọta nwere ike ịdị iche dabere na pH. A na-enyocha ya kwa awa 2 ọ bụla: ọgwụ infusion na-aga n'ihu ruo mgbe pH ruru ihe karịrị 7.0.

Ọ bụrụ na onye nwere ọrịa mamịrị na hyperlactacidemia nwere akụrụ gbasara akwara, mgbe ahụ a na-eme akụrụngwa nke akụrụ.

O kwere omume igbochi mmepe nke ọrịa obi ike site na ịdepụta ọgwụ ndị pụrụ iche. Na obere doses, Reopoliglukin, Heparin ka a ga-edenye. Nhọrọ nke usoro insulin zuru oke di nkpa. Nke a ga-ahazi metabolism metabolism.

Site na mmepe nke lactic acidosis coma, ọgwụ nje na-agbadata nye onye ọrịa. N'otu oge ahụ na-eme ọgwụgwọ antishock. A na-eji Trisamine belata ngosipụta nke lactic acidosis.

Ihe puru omume nke ibido usoro a dika oge nlebara anya nye ulo akwukwo ogwu bu 50%. Ọ bụrụ n’inwe oge ma notaghị ntị na mgbaàmà nke ọrịa a na - aga n’ihu n’ihu, mgbe ahụ ọnwụ nwere ike iru 90%. N’ọnọdụ ndị leghaara anya, ọbụna ndị dọkịta agaghị enwe ike ịzọpụta onye ọrịa.

Kedu otu esi emeso ọgwụgwọ lactic acidosis?

Lactic acidosis, ma ọ bụ lactic acidosis, bụ ọnọdụ ebe enwere ngwa ngwa mmụba na ọkwa lactic acid na ọbara mmadụ. A naghị ewepụ acid a ngwa ngwa ọ na-agbakọta, ọbara mmadụ na-aghọkwa acidic. Losic acidosis nwere ike ịdị ize ndụ, ndị ọ na-eme nwere ike ịchọ nlekọta ahụike.

Inggwọ ọnọdụ a nwere ike ịchọ ụlọ ọgwụ, mgbochi mmiri ara, ọgwụ ma ọ bụ ọgwụ mgbochi, na mgbe ụfọdụ ọbụna ọgwụgwọ akụrụ na-enyere aka wepu lactic acid n'ọbara. Nhọrọ nke usoro ọgwụgwọ kwesịrị ekwesị na-adaberekarị n'ịdị ogo nke lactic acidosis, yana ihe kpatara akpata ya.

Ndị na-eme egwuregwu na-enwekarị oge nke lactic acidosis n'ihi ọzụzụ siri ike. N'oge ọrụ siri ike, akwara na-enwe ike iji oxygen ngwa ngwa nke ahụ na-enweghị oge iji tụgharịa ikike ya.

Ndụmọdụ! Na enweghi oxygen zuru ezu ịhazi lactic acid, acid a na - eto n’ime ọbara, na - eme ka iku ume dị mkpụmkpụ ma nwee mmetụta dị ọkụ na ike ọgwụgwụ. Cticdị lactic acidosis a dị nro ma ọ naghị achọ ọgwụgwọ ọ bụla na-abụghị inye izu ike na akwara.

Mgbe onye na-eme egwuregwu na-ezu ike, ahụ na-amalitekarị ịlaghachi n'onwe ya, ọ nweghị mmetụta na-adịgide adịgide ma ọ bụ nke dị njọ na-eme.

Lactic acidosis n’ime ọrịa shuga

N'ime ihe banyere etioloji, inyocha biguanides ogologo oge buru ihe di iche. Ọbụlagodi obere ọgwụ ọgwụ ndị a (n'okpuru ọnụnọ nke akụrụ ma ọ bụ ọrịa hepatic) nwere ike kpalite ọdịdị nke lactic acidosis.

Ihe fọrọ nke nta ka ọ bụrụ ọkara nke ikpe lactic acidosis na-etolite na ndị ọrịa nwere ọrịa mellitus.

Mgbe ị na-agwọ onye ọrịa na biguanides, mmepe nke lactic acidosis na-apụta n'ihi nrịba ahụ nke pyruvic acid (pyruvate) site na membranes nke cellular mitochondria. N'okwu a, pyruvate na-arụsi ọrụ ike malitere ịtụgharị na lactate. Oke lactic acid na-abanye n'ọbara, wee banye n'imejuju, ebe a na-atụgharị lactic acid ka ọ bụrụ glycogen. Ọ bụrụ na imeju anaghị anabata ọrụ ya, lactic acidosis malitere.

Ihe mkpali ndi ozo

Ihe ndị a na - esote nwere ike ịkpalite ihe ndị na - emetụta oke oke n'ahụ ahụ lactic acid na mellitus ọrịa shuga:

hypoxia muscle (agụụ oxygen) na mgbatị anụ ahụ,
nsogbu iku ume izuru oke (dysfunction),
ụkọ vitamin (otu ìgwè B),
mmanya na-egbu egbu,
nnukwu nsogbu myocardial,
ọrụ ezughi oke,
nnukwu ọbara ọgbụgba
site na afọ 65,
tụụrụ ime

Isi ihe na - eme ka mmepe nke lactic acidosis bụ agụụ oxygen (hypoxia). N'okpuru ọnọdụ ọghọm oxygen dị ukwuu, nchịkọta nke lactic acid na-arụ ọrụ (ọ na-akpalite mkpokọta lactate na anaerobic glycolysis).

Site na nkesa carbohydrate na-enweghị oxygen, ọrụ nke enzyme na-ahụ maka ntụgharị nke pyruvic acid na acetyl coenzyme A na-ebelata. N'okwu a, pyruvic acid na-agbanwe ghọọ lactate (lactic acid), nke na-eduga na lactic acidosis.

Ihe kpatara ya na oria ndi nwere ike ibute lactic acidosis

Enwere ike ịhụ mmepe nke ọrịa ahụ na-adabere na ihe ọ bụla na ọrịa ọ bụla na-eduga na imebi anụ ahụ nke oxygen, na-agbaze glucose n'ụzọ enweghị ikuku.

Oldestzọ kachasị ochie eji, akpọrọ usoro glucose na sel, na-eme nke ọma n'ọnọdụ ndị na-akpata nrụgide, dịka ọmụmaatụ, n'oge ịgba ọsọ, igwu mmiri, mmega ahụ na ọtụtụ ihe ndị ọzọ. N'ime ihe ndị na-adịghị ndụ, a na-ahapụ lactic acid n'ime gburugburu; nnukwu ọkpụrụkpụ na-eme na-enweghị nsogbu ọ bụla.

N’ime ahụ mmadụ dị ọtụtụ, ọ na-eyi ndụ egwu. N'ọtụtụ oge, a na-eji ụdị nbibi ma ọ bụ sọks glucose n'ọbara, emejupụta acid acid.

Tupu ngosipụta nke lactic acidosis, enwere ụfọdụ ihe kpatara mmepe nke ọrịa a:

Otute na nje
Nnukwu ọbara ọgbụgba
Ọrịa imeju (ịba ọcha n'anya, ọrịa nhụjuanya, ụkọ, jaundice),
Myocardial infarction
Alcoholism
Nsogbu ojoo.

Dika ogo nke ulo ogwu a, ogo nke uzo di iche na uzo ato nke lactic acidisis: n’isi, etiti na n’azu. Mmepe ha na-eme ngwa ngwa, n'ime awa ole na ole ihe mgbaàmà ahụ na-akawanye ike site na adịghị ike n'ozuzu ya ruo coma. Nkewa ozo dabere na usoro etiopathogenetic na-ebute nsogbu. Dabere na ya, a na-amata ụdị hyperlactatacidemia abụọ:

Zụrụ (Adị A). Emekarị debuts mgbe afọ 35 gasịrị. Ọ bụ imebi inye oxygen na ọbara n’arụ ahụ. A na-ahụ ihe iriba ama akparamagwa nke metabolic acidosis - a na-egbochi ọrụ CNS, ọnụego iku ume na ọnụego obi na-agbanwe. A na-enyocha mmekọrịta dị n'etiti ọkwa lactacidemia na akara akwara. Oria mamiri, enwere ike nke puru ibu ugha, mbelata nke obara.
Ọkpụkpụ (ụdị B). Ọ na - apụta site n’ọmụmụ, ọ na - esitekarị n’oge ọ bụ nwata, na - ezo aka n’ụdị nke usoro nsogbu ahụ ike. Site na ụbọchị mbụ nke ndụ, a na-ekpebi nsogbu akwara ozi na akụkụ iku ume: myotic hypotonus, areflexia, stupefaction, dyspnea, polypnoea, njiri mara njirimara nke ashma.

Gịnị bụ lactic acidosis?

A na-akpọ Lactic acidosis (lactic acidosis) mmụba nke ọdịnaya nke lactic acid n'ime ọbara. Nke a na - ebute nsonaazụ ya na arụpụta yana akụrụ na umeji. Nke a bụ ọnọdụ a na-adịghị ahụkebe, nke na-ebute ọrịa ụfọdụ.

Ihe dị mkpa: Ọ bụ otu n'ime nsogbu nke ọrịa shuga na ọrịa ndị agadi. Ohere ịnwụ - karịrị 50%

Ihe na-eme ka acid a dị n’ime ahụ bụ ihe na-emepụta glucose. Ngwakọta ya adịghị mkpa oxygen, a na-akpụ ya n'oge anaerobic metabolism. Imirikiti acid na-abanye n'ọbara site na akwara, ọkpụkpụ na anụahụ.

N’ọdịnihu, lactates (nnu nke lactic acid) kwesịrị ịgafe n’arụ akụrụ na imeju. Ọ bụrụ na usoro a na-enye nsogbu, ọdịnaya acid na-abawanye ngwa ngwa ma na-emegharị. A na-ehibe akwa lactate n’ihi nsogbu metabolism dị ukwuu.

A na - ahụta ọrịa ụbụrụ na njikọta na mkpochapu - ọrịa akụrụ, ọbara ọbara na - agụta ọrịa.

Njikwa lactates dị mkpa maka ndị na-eme egwuregwu, ebe ọ bụ na ibu ha nwere ike iburu ibu dị ukwuu.

Lactic acidosis bụ nke ụdị abụọ:

Adị A - nke kpatara enweghị oxygen oxygen anụ ahụ ma na-ebute n'ihi nsogbu iku ume, ọrịa obi, ọrịa anaemia, nsị.
Bdị B - na - aputa ihe na-akpata na njikọta na acid na - ekwesịghị ekwesị. A na-emepụta acid aactụ acid karịrị akarị ma ọ naghị etinye ya n'ọrụ na ọrịa shuga mellitus, ọrịa imeju.

Lactic acidosis na-ebutekarị:

oncological ọrịa (lymphomas),
ọrịa na-arịa ọrịa shuga
mmebi akụrụ na-adịghị ala ala (ụdị siri ike nke glomerulonephritis, nephritis),
pathology nke imeju (ịba ọcha n'anya, cirrhosis),
ọrịa mkpụrụ ndụ ihe nketa
nsi, tinyere ndị ọgwụ ọjọọ na-akpata (, Fenformin, Methylprednisolone, Terbutaline na ndị ọzọ),
ọrịa na-efe efe siri ike
nsi mmanya na-egbu egbu,
Akwụkwụ na-adọ adọ.

Ọtọ lactate / pyruvate dị n’ọbara (10/1) dị ezigbo mkpa. Imebi ihe a kwesiri iru

A na - ekpebi ọkwa nke ọdịnaya lactate site na iji nyocha nke biochemical. Edeghị ụkpụrụ dị ka ụkpụrụ mba ụwa si dị, ebe ha dabere na usoro nyocha na ihe ejiri.

Maka ndị okenye, ngosipụta nke ọkwa ọbara dị mma bụ na oke 0.4-2.0 mmol / L.

Ihe mgbaàmà nke acidosis na-adabere ogo nke pH gaa n'akụkụ acidic. N'ihe banyere ụdị akwụrụ ụgwọ akwụkwụ, usoro mgbaàmà adịghị adị ma ọ bụ na ha dị obere ma bụrụ nke a na-ahụkarị, na-enwe mmụba nke ngwaahịa acidic, adịghị ike, ike ọgwụgwụ ga-apụta, iku ume ga-agbanwe, ujo na coma ga-ekwe omume.

Enwere ike ịchịkwa mgbaàmà nke acidosis site na ngosipụta nke ọrịa na-akpata ya ma ọ bụ yie ya nke ukwuu, nke na-eme ka nchọpụta siri ike. Mita acidosis na-abụkarị asymptomatic, siri ike - ọ na-enye ụlọ ọgwụ mgbe niile iku ume iku ume, ọ ga-ekwe omume belata nkwekọ nke akwara obi na mmeghachi omume nke akụrụngwa akwara ụkwụ na adrenaline, nke gụnyere akpata ụjọ na coma.

Metabolic acidosis na-esite na oke njiri mara akụkụ iku ume nke ụdị Kussmaul, nke a na-ezube iweghachi nguzozi acid-site na ịbawanye omimi nke mmeghari iku ume, ebe a na-ewepụta ụba carbon dioxide n'ime ikuku gbara ya gburugburu.

Site na oghere iku ume (ikuku iku ume) acidosis kpatara mbelata nke mgbanwe ikuku alveolar, iku ume ga-aghọ nke na-emighị emi, ikekwe ọ ga-eme ngwa ngwa, mana ọ gaghị amami omimi, ebe ọ bụ na alveoli enweghị ike ịnye ọkwa nke ikuku na mgbanwe.

Ihe omuma nke oma banyere ntinye carbon dioxide n’ime ọbara onye oria, nke dibia nwere ike inweta n’enweghi usoro nyocha ozo, ka ana-enye site na ntule udi udi iku ume Mgbe ọ mechara doo anya na onye ọrịa nwere acidosis n'ezie, ndị ọkachamara ga-achọpụta ihe kpatara ya.

Udiri nsogbu nchọpụta kachasị na-ebilite na acidosis nke iku ume, ihe ndị na-abụkarị nke a na-ahụ nke ọma. Ọtụtụ mgbe, ihe na - akpalite ahụ bụ ihe na - egbochi mmetụta azụ, oyi baa, ụkwara ume ọkụ n'etiti. Iji kọwaa ihe kpatara metabolic acidosis, a na-eduzi ọtụtụ ọmụmụ ọzọ.

Egosiputa acidosis a kwụrụ ọtọ na-aga n’ihu n’enweghi ihe mgbaàmà ọ bụla, na nchoputa ahụ gụnyere n’inyocha usoro ọbara, mmamịrị, wdg. Mgbe ogo nke ọgbụgba omimi miri emi, ụdị iku ume.

Na ọgbụgba nke acidosis, ọgba aghara na-eme n'akụkụ ụbụrụ, obi na arịa ọbara, ọnya nri, nke metụtara usoro ischemic-dystrophic megide mmalite nke hypoxia na mkpokọta acid acid. Mmụba na mkpokọta homonụ nke adrenal medulla (adrenaline, norepinephrine) na-enye aka na tachycardia, ọbara mgbali elu.

Onye ọrịa nwere mmụba nke catecholamines na-enwe palpitations, na-eme mkpesa nke mmụba obi na mgbanwe n'ọbara. Ka acidosis na-akawanye njọ, arrhythmia nwere ike isonye, mgbe mgbe spasm nke bronchi na-amalite, nzuzo nke geses diges na-abawanye, yabụ, ọgbụgbọ na ọnya afọ nwere ike ịbụ otu n'ime ihe mgbaàmà ahụ.

Mmetụta acidation nke gburugburu ebe obibi na ọrụ nke ụbụrụ na-akpalite ụra, ike ọgwụgwụ, enweghị ike, enweghị mmasị, isi ọwụwa. N'okwu ndị siri ike, mmụọ na-egosipụta onwe ya dịka ọma (maka ọrịa shuga, dịka ọmụmaatụ), mgbe onye ọrịa anaghị anabata mkpali mpụga, ụmụ akwụkwọ ahụ nwere ume, iku ume na-adịkarị ụkọ, na-ebelata ụda olu.

Site na acidosis nke iku ume, ọdịdị onye ọrịa na-agbanwe: akpụkpọ ahụ na-agbanwe agba site na cyanotic gaa pinkish, na-ekpuchi ya ọsụsọ, afụ ọnụ nke ihu na-egosi. Na mmalite nke acidosis akụkụ okuku ume, onye ọrịa ahụ nwere ike iwe iwe, obi ụtọ, na-ekwu okwu, na agbanyeghị, na-enwe ngwaahịa acidic n'ime ọbara, omume ahụ na-agbanwe kwupụta enweghị mmasị, iro ụra. Deusenses na iku ume acidosis na-aputa ihe na nzuzu na coma.

Mmụba na omimi nke acidosis na pathology nke usoro iku ume yana hypoxia na akwara, mbelata uche ha na carbon dioxide, na nkụda mmụọ nke etiti iku ume na medulla oblongata, ebe mgbanwe ikuku na ngụgụ parenchyma ji nwayọ belata.

A na-etinye metabolic na sistem nke iku ume nke acid-base. Onye ọrịa ahụ amụbaala na tachycardia, ihe egwu na-akpata ọgba aghara nke obi, ọ bụrụ na amaliteghị ọgwụgwọ, Coma ga-ebilite nwere nnukwu ihe egwu.

Ọ bụrụ acidosis sitere na uremia megide mmalite nke ọdịda akwara na-adịghị ala ala, mgbe ahụ, ihe mgbaàmà ahụ nwere ike ịgụnye nkwarụ metụtara mkpokọta kalsia n'ọbara. Site na mmụba nke urea n'ọbara, enweghị iku ume ga-abụ mkpọtụ, njiri mara amonia ga-apụta.

Ọnọdụ a enweghị ihe mgbaàmà njirimara ọ bụla. Mgbanwe nke acidity na otutu onu ogugu di iche iche na - eso gi, nke nwere ike isi ike ichota onwe ya. Ọ bụ ya mere o ji esi ezigbo ike ịmata ọrịa ahụ n'ụlọ.

Ihe ngosi a na-ahụkarị nke enwere ike ịhụ ụdị ọrịa a gụnyere:

Mgbe niile ọgbụgbọ na ọgbụgbọ na ọgbụgbọ, mgbe ọ nwechara ọ bụla na-adịwanye mma,
Adịghị ike na-eme ka onye ọrịa nọrọ n'ihe ndina,
Ọdịdị nke dyspnea na izu ike. Mmadu “ume iku ume”, n'ihi na iku ume ya na –eme karia ma di omimi,
Pallor nke anụ ahụ na akpụkpọ ahụ anya (anya, ọnụ na oghere imi),
Ọdịdị oyi ọsụsọ na anụ ahụ,
Ọsụsọ na ebidata ọbara,
Ikekwe mmepe nke ihe ọdịdọ, oké dizzness na ọnwụ nke nsụhọ (ruo coma).

Dị ka anyị kwuru, mgbanwe nke acidity anaghị adị n'onwe ya. Ọrịa a na-ebutekarị ọrịa a. N'okwu dị mfe, enwere ike ikwu na ndagide dị mma na ọdịmma n'ihi ọrịa na-abụkarị mgbaàmà mbụ. N'okwu a, ọ dị mkpa ịkpọ ndị otu ụgbọ ihe mberede, nke ga-enyocha ọnọdụ ahụ, ma ọ bụrụ na ọ dị mkpa, gaa ụlọ ọgwụ. N'ụlọ ọgwụ, ndị dọkịta ga-achọpụta nyocha ikpeazụ, na-eduzi ọmụmụ dị mkpa na usoro ọgwụgwọ.

A na - amata ụdị nsogbu ndị a dị ka usoro mmepe acidosis:

Acidosis na-abụghị akụkụ okuku ume,
Acidosis ume iku ume (inhalation nke ikuku nwere oke ikuku carbon dioxide),
Aciddị acidosis agwakọtara (ọnọdụ kpatara ụdị acidosis dị iche iche).

Acidosis na-abụghị okuku ume nọ n'okpuru aka nkewa ndị a:

Acidosis Excretory - ọnọdụ na - ebilite mgbe enwere mmebi nke ọrụ iwepu acid na ahụ (arụ ọrụ ezigharị ọrụ)
Metabolic acidosis bụ ọnọdụ kachasị mgbagwoju anya nke ejiri ngụgụ nke acid endogenous na anụ ahụ nke anụ ahụ,
Acidosis na-ebu ibu bụ ọnọdụ nke ịba ụba ịta acid n'ihi ntopute nke ọtụtụ ihe ndị a gbanwere ghọọ acid n'oge metabolism.

Dika ọkwa pH, a na - eke acidosis dika:

Kwụrụ ụgwọ
Ihe gbara ọkpụrụkpụ
Na-agbagha.

Ozi izugbe

Lactic acidosis na Latin pụtara "lactic acid". A na-akpọkwa ọnọdụ ahụ lactacidemia, lactic coma, hyperlactatacidemia, lactic acidosis. Na ICD-10, a na-ekenye pathology na otu nsogbu nke mmiri-nnu na acid-base balance (klaasị - ọrịa oria Endocrine). Nke a bụ ụdi siri ike. Achọpụtabeghị data ọrịa na - efe efe, mana achọpụtara na ihe dị ka ọkara nke ikpe a bụ ndị ọrịa chọpụtara ọrịa shuga mellitus. N'ime otu ndị ọrịa a, dị ka ọmụmụ ndị si mba ọzọ, ugboro ole nke lactic acidosis bụ 0.006-0.008%. Mmepe na nsogbu esiteghi na nwoke na nwanyị, a na-edebanye aha ya na ndị gbara afọ 35 ruo 84.

Ihe na-akpata Lactic Acidosis

Lactic acidosis nwere ike ịbawanye site na ịba ụba nke mmepụta nke lactate, ntụpụ ezughi oke ya site na akwara gbasara akwara na / ma ọ bụ nsogbu metabolic na imeju, nke mmebi nke pyruvate na ịmepụta glucose site na nchịkọta ndị na-enweghị carbohydrate. Ihe kpatara metabolism ndị a bụ:

Ọrịa ketara eketa nke metabolism. Enwere ụdị mkpụrụ ndụ ihe nketa nke acidosis. Site na ya, a na-ahụta mmebi iwu n'ọkwa nke enzymes nke carbohydrate metabolism, a na-ahụ ihe mgbaàmà ozugbo amụchara.
Ọrịa shuga mellitus. Ọtụtụ mgbe, nchịkọta nke lactate bụ n'ihi ojiji nke biguanides - ọgwụ hypoglycemic. Ihe ọghọm nke imebi na-abawanye na umeji ọrụ akụrụ, ụnwụ oxygen nke anụ ahụ mgbe a gbasịrị ume, ụkọ iku ume, ụkọ vitamin, ị alcoholụ mmanya na afọ ime.
Ọrịa obi. Lactacidemia ka etinyere na ọrịa obi, nke nsogbu ọbara na-ewedata, mgbe ọ gbasịrị akụrụngwa obi site na iji AIK, ya na sepsis, hypovolemic na akpata obi mgbawa na DIC. Ọrịa acidosis na-abawanye ngwa ngwa.
Ọnọdụ mgbapụta. Lactic acidosis nwere ike ịmalite ọrịa kansa (ọkachasị na pheochromocytoma), n'ime ndị ọrịa nọ na nkụ ma ọ bụ ujo. A na-akpatakwa nsogbu ahụ site na ọnya dị ukwuu, akụrụ na umeji.
Mmanya Ihe ize ndụ nke lactic acidosis na-abawanye na mmanya. Whomnye ka carbon monoxide, ethylene glycol, methanol, nnu nke salicylic na hydrocyanic acid, chlorides potentiates.

Ihe eji eme ihe na-egosi Lactic acidosis site na mmụba na-adịgide adịgide na lactic acid, acid acid ọbara. Lactic acid bụ isi iyi nke ike, mana, n'adịghị ka glucose, metabolism ya na-adị anaerobically (na-enweghị gụnyere oxygen na mmeghachi omume). A na-arụpụta ya site na sel ọbara ọbara, akwara nke akwara, akwara anụ ahụ na sistem nke akwara, akụrụ, eriri afọ, akwara, na tumo neoplasms. Ntọlite etolite lactate na-abụkarị hypoxia, nke ntụgharị nke glucose na adenosine triphosphate na-aghọ ihe na-agaghị ekwe omume.

Na mgbakwunye, lactic acidosis bụ nke ezughi oke iji acid mee ihe site na akụrụ na imeju. Otu ụzọ usoro ọgwụgwọ bụ ihe mebiri gluconeogenesis, ebe a na-atụgharịkarị lactate ka ọ bụrụ glucose ma ọ bụ oxidized kpamkpam n'ụdị usoro njikọ citric acid. Additionalzọ ọzọ mkpofu - excretion site na akụrụ - na-arụ ọrụ mgbe ọnụahịa lactic acid dị ka 7 mmol / l. Site na akụrụngwa lactic acid, a na-ahụ ntụpọ site na njikọ nke enzymes dị mkpa maka mmebi nke pyruvic acid ma ọ bụ ntụgharị nke ogige ndị na-enweghị carbohydrate na glucose.

Nkewa

Enweta (ụdịA). Emekarị debuts mgbe afọ 35 gasịrị. Ọ bụ imebi inye oxygen na ọbara n’arụ ahụ. A na-ahụ ihe iriba ama akparamagwa nke metabolic acidosis - a na-egbochi ọrụ CNS, ọnụego iku ume na ọnụego obi na-agbanwe. A na-enyocha mmekọrịta dị n'etiti ọkwa lactacidemia na akara akwara. Oria mamiri, enwere ike nke puru ibu ugha, mbelata nke obara.
Na nkenke (ụdịB). Ọ na - apụta site n’ọmụmụ, ọ na - esitekarị n’oge ọ bụ nwata, na - ezo aka n’ụdị nke usoro nsogbu ahụ ike. Site na ụbọchị mbụ nke ndụ, a na-ekpebi nsogbu akwara ozi na akụkụ iku ume: myotic hypotonus, areflexia, stupefaction, dyspnea, polypnoea, njiri mara njirimara nke ashma.

Mgbaàmà nke Lactic Acidosis

Mkpakọ

Lactic acidosis bụ nnukwu ihe egwu n'ihi nnukwu ihe ọrịa ụbụrụ na ọnwụ. Ohere nke ọnwụ na-abawanye na enweghị nlekọta ahụike na awa ndị na-abịa mgbe mmalite nke mgbaàmà mbụ. Nnukwu ụbụrụ na hypoxia nke ụbụrụ na-eduga n'ọzụ nke ọrịa ụbụrụ dị iche iche, ụkọ akwara ozi. Mgbe oge adịghị anya, ndị ọrịa na-eme mkpesa maka ogologo oge nke akpịrị, isi ọwụwa. Enwere ike ikwu okwu na ncheta, na-achọ usoro nrụpụtagharị.

Ọgwụ ọgwụgwọ acidosis

Ọgwụ ọgwụgwọ ụdị afọ nke lacticacidemia bụ nke a na-eme na ọkwa. Nke mbu, ana ewepu ihe ndi mmadu na achoghi ihe ndi ozo, mgbe emechara nri puru iche: a na-edozi nsogbu gluconeogenesis site na inye nwa nri ugboro ugboro na nri carbohydrate, nkwụsị ya na okirikiri oxriation pyrivate chọrọ mmụba na oke abụba na nri, ọdịnaya ha kwesịrị iru 70% nke ọdịnaya kalori kwa ụbọchị. Ọgwụgwọ n'ụdị lactic acidosis ezubere iji weghachite nguzo electrolyte, ịlụso acidosis, hyperglycemia, ọnọdụ ụjọ na agụụ oxygen. Usoro ndị a na-arụ ọrụ:

Hemodialysis, infusion. Ihicha ọbara n’anụ ahụ bụ ụzọ kachasị mma iji wee gbochie nnukwu lactate n’usoro sistem. A na-edozikwa usoro glucose n'ọbara. N’ime ya, a na-eme insulin insulin. Dị ahụ siri ike na-akpali ọrụ nke enzymes pyruvate dehydrogenase na glycogen synthetase.
Ikuku ume na umeji. Mwepu nke carbon monoxide guzobere n'ihi mmebi nke nguzozi pH bụ nke a na-ebu site na usoro ikuku ikuku. Ntinye nke alkaline itule na-eme mgbe ntinye nke carbon dioxide na plasma na-agbadata rue 25-30 mm RT. Art. Uzo a na-ebelata oke ntinye nke lactate.
Drugsakingụ ọgwụ kadiotonic. Ọgwụ nke otu a na - akpali ọrụ ngozu nke akwara obi, weghachite ụsụ ahụ. A na-eji Cardlyac glycosides, ndị na-ahụ maka adrenergic, cardiotonics na-abụghị glycoside.

Amụma na Mgbochi Ya

Nsonaazụ nke lactic acidosis bụ ihe dị mma maka ọgwụgwọ na-aga nke ọma nke ọrịa na-akpata, oge na ogo nke ọgwụ infusion.Prognosis ahụ dabakwara n'ụdị lactacidemia - nlanarị dị elu n'etiti ndị nwere ụdị ọrịa a na - arịa ọrịa A (enwetara). Mbelata belata na mgbochi hypoxia, ị intoụbiga mmanya ókè, ọgwụgwọ ziri ezi nke ọrịa shuga na ịgbasochi usoro biguanides n'otu n'otu na kagbuo ya ozugbo banyere ọrịa oria (oyi baa, flu). Ndị ọrịa sitere na otu ihe dị egwu - yana nchọpụta ọrịa shuga gbakwunyere na ịtụrụ ime, ime agadi - ga-akpachara anya nyochaa ọnọdụ nke ha, na akara mbụ nke mgbu na adịghị ike, na-achọ ndụmọdụ ahụike.