Kodi glucagon wamafuta ndi glucagon wa mankhwala ndi chiani?

Glucagon ndi amodzi mwa mahomoni ambiri m'thupi lathu. Amachita masewera olimbitsa thupi komanso mitundu ina ya kagayidwe. Chifukwa cha glucagon, kudziwitsa bwino shuga m'magazi ndikotheka. Imagwira ntchito molumikizana ndi insulin: ngati kuli kofunikira, imachepetsa mphamvu yake; pambuyo matenda a glycemia, m'malo mwake, kumalimbikitsa. Mankhwala omwe ali ndi glucagon ndi njira yothandiza yoperekera thandizo mwadzidzidzi, amagwiritsidwa ntchito kuti athetse vuto la hypoglycemic precoma ndi chikomokere.

Glucagon ndi Metabolism

Zikondwererozi zimagwira ntchito zingapo. Exocrine imapanga kupukusa kwam'mimba, yomwe imapukusidwa kudzera mu ma ducts mu duodenum 12. Ntchito ya endocrine ndikupanga ndikumasulidwa mwachindunji m'magazi a polypeptides ndi mahomoni: insulin, glucagon, somatostatin, ghrelin ndi ena. Kuphatikizika kwa zinthu izi kumalimbikitsidwa muzilumba za Langerhans, ntchitozi zimagawidwa pakati pamagulu angapo amitundu. Glucagon imapangidwa ndi ma cell; amaŵerengetsa pafupifupi 20% ya maselo onse am'misamba yopanda pancreatic.

Glucagon amatanthauza mahomoni a polypeptide, amakhudza mitundu yonse ya kagayidwe. Ntchito yayikulu ya glucagon ndikutsutsana ndi insulin:

Mwa munthu wathanzi, shuga wamagazi sasintha kwambiri, atatha kudya amapita mwachangu. Kuongolera glycemia ndi njira yovuta, yomwe imaphatikizapo ubongo, m'mimba, minofu, zodutsitsa za pituitary, chithokomiro ndi kapamba, impso, chiwindi ndi ziwalo zina. Chifukwa cha ntchito yawo yoyendetsedwa, mulingo woyenera wa glucose wa metabolism umasungidwa.

Kuphatikizika kwa thupi

Ngati shuga m'magazi amatsika chifukwa chochita zolimbitsa thupi kapena kusowa kwa chakudya, kaphatikizidwe ka glucagon kamawonjezeka kwambiri. Zomwe zimachitika izi zikachitika:

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

• Matenda a shuga -95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%

1. Masitolo a Glycogen omwe amasungidwa pachiwindi amakhudzidwa. Glycogen amawonongeka, amaponyedwa m'magazi ngati glucose, glycemia amakhala ngati. Mphamvu ya glucagon sigwiritsa ntchito ma glycogen amana mu minofu minofu.
2. Chiwindi chimayamba kupanga mwachangu glucose kuchokera ku pyruvate ndi zinthu zina zopanda mafuta.
3. Kugwiritsa ntchito shuga pakupanga mphamvu kumachepetsa.
4. Zofunikira zamthupi zimayamba kukhuta chifukwa cha minofu yamafuta, kuchuluka kwamafuta m'magazi kumawonjezeka. Nthawi yomweyo, matupi a ketone, zopangidwa ndi kuwonongeka kwamafuta, amayamba kulowa m'magazi.
5. Kutulutsidwa kwa glucagon, kupanga kwa insulini kumakwera. Chifukwa cha kuthana nawo, hyperglycemia imaletsedwa.
6. Glucagon yamagalasi imapereka kukhudzidwa kwa mtima, kuwonjezeka kwa mphamvu ndi pafupipafupi kwake. Chifukwa cha kuchuluka kwa kupsinjika, thanzi lathupi lonse lathupi limayenda bwino.
7. Kutulutsidwa kwa makatekolamaini kumachulukitsa, kutulutsa kwamkati kumachitika. Munthu akhoza kukhala ndi mantha, kukwiya. Zizindikiro zowoneka bwino zoterezi zimakupangitsani kuti musamale ndi vuto lanu ndikuchotsa hypoglycemia.
8. Pakukhudzidwa kwakukulu, mahomoni amakhala ngati antispasmodic: amatsitsa minofu yamatumbo.

Glucagon amapangidwa poyankha kutsika kwa glycemia, kuchuluka kwa insulin. Kuphatikizika kwa Glucagon kumalimbikitsidwa ndi dongosolo laumwini la autonomic, kotero kupanga kwake kumawonjezeka ndikugwiritsa ntchito sympathomimetics ndi adrenostimulants.

Mwazi waukulu wamagazi, matupi a ketone owonjezera komanso mafuta acids m'mitsempha yamagazi, komanso milingo yamtundu wa somatostatin imasokoneza kupanga kwa glucagon.

Kugwiritsa ntchito shuga

M'magawo oyamba, hypoglycemia imalepheretsedwa mosavuta ndi makonzedwe amkati a zakudya zilizonse zofunikira: uchi, shuga, maswiti, misuzi yazipatso. Ngati mphindi iyi yakusowa ndipo wodwalayo afooka, pali njira ziwiri zokulitsira glycemia: popereka shuga kapena glucagon. Kwa glucose, makonzedwe amkati amafunika, motero, sioyenera kukhala othandizira osunthira mwachangu. Koma glucagon amatha kubayidwa intramuscularly, ndipo pogwiritsa ntchito njira iyi, amayamba kuchita pambuyo mphindi 5 mpaka 15.

Kapangidwe ka glucagon m'mamayi onse ndi pafupifupi chimodzimodzi; mwa anthu, mahomoni a nyama amatha kugwiritsidwa ntchito bwino. Poletsa hypoglycemia, mankhwala omwe amapezeka kuchokera ku ng'ombe kapena kapamba wa nkhumba amagwiritsidwa ntchito nthawi zambiri. Kapangidwe ka glucagon ndikodziwika, chifukwa chake, kupanga kwa mahomoni kwakhazikitsidwa pogwiritsa ntchito njira zopangira ma genetic.

Pakadali pano, pali mankhwala amodzi okha a glucagon omwe adalembetsedwa mu renti la mankhwala aku Russia - GlucaGen HypoKit, opangidwa ndi kampani yaku Danish NovoNordisk. Zomwe zimagwiritsidwa ntchito momwemo ndi glucagon hydrochloride, yopangidwa ndi njira zogwiritsira ntchito labotale, pogwiritsa ntchito mtundu wosandulika wa bacterium Escherichia coli. Zomwe zimagwiritsidwa ntchito zili ngati mawonekedwe a ufa, wophatikizidwa mu botolo lagalasi.

Bokosi limaphatikizapo botolo lokhala ndi 1 mg ya glucagon ufa, syringe ndi solvent, cholembera pensulo yosavuta kunyamula mankhwala panu, malangizo. Mtengo wa zomwe zakonzedwazo ndikuchokera ku ruble 635 mpaka 750.

Kusankhidwa

Munda womwe ukugwiritsidwa ntchito kwa mankhwalawa ndi mpumulo wa hypoglycemia panthawi yomwe kutsekemera kwa kamwa kwa glucose sikungatheke chifukwa chitha kuzindikira kapena kusachita bwino. Zomwe zimayambitsa hypoglycemia zimatha kukhala kuchuluka kwa insulin, mankhwala ena okhudzana ndi matenda ashuga, njala, kupsinjika kwa nthawi yayitali.

M'malo azachipatala, glucagon amagwiritsidwa ntchito ngati imodzi mwazithandizo zadzidzidzi poizoni wambiri ndi mankhwala osokoneza bongo. Itha kugwiritsidwanso ntchito pakuwunika kwa m'mimba motayirira ngati njira yopumitsira minofu.

Machitidwe

Ntchito yayikulu ya glucagon ndikumemeza masitolo a glycogen. Homoni yoyambitsayo imayambira njira ya glycogenolysis, chifukwa chomwe glycogen imasweka m'chiwindi kupita ku phosphorylated glucose. Nthawi yoyambira ya mahomoni imatengera njira yoyendetsera. Ndi mtsempha wamagazi amkati amayamba kukula pambuyo pa mphindi 1, zotsatira zake zimakhala mpaka mphindi 20. Njira yotsogola ya makonda imakondedwa ngati simuli katswiri wazachipatala. Glycemia imayamba kuchuluka pambuyo pa mphindi 5. Mphindi 10 pambuyo pa jakisoni, wodwalayo nthawi zambiri amayambiranso kuzindikira. Kutalika kokwanira kwa zochita kumafika mphindi 40. Ndi subcutaneous makonzedwe, kuyamwa kwa glucagon m'magazi ndiye wosachedwa kwambiri - kuchokera theka la ora.

Mankhwala ndi osathandiza kwa odwala omwe achedwa glycogen nkhokwe. Zomwe zimayambitsa kusowa kwa glycogen zimatha kukhala matenda ashuga omwe amakhala ndi hypoglycemia pafupipafupi, zakudya zamafuta osapatsa mafuta, njala, uchidakwa, kuledzera, kutsata shuga. Glycogen sangakhale wokwanira ndi mankhwala osokoneza bongo ambiri omwe amachepetsa shuga.

Malamulo oyambira

Glucagon imayenera kukonzekera kuyang'anira. Ndondomeko

1. Timachotsa kapu m'botolo, ndi kapu ku singano ya syringe.
2. Ikani singano mu cholembera, kuti mumasule madzi onse mu syringe kulowa.
3. Popanda kuchotsa singano, gwedezani valayi kwa mphindi imodzi kuti mumalize ufa.
4. Tisonkhanitsa yankho lomalizidwa mu syringe.
5. Kwezani syringe ndi singano mmwamba, kumasula mpweya ndikanikizira pistoni.

Jakisoni amatha kuchitidwa minofu iliyonse, koma bwino pabowo kapena ntchafu. Malinga ndi malangizo ogwiritsira ntchito, akulu amapatsidwa yankho lonse, ophunzitsira komanso ana olemera osakwana 25 kg - theka la mahomoni. Munthu wodwala matenda ashuga atayambanso kudziwa bwino, ayenera kupatsidwa shuga kuti amwe: yankho la mankhwala, tiyi wokoma kapena msuzi. Ngati odwala sanasinthe kwa mphindi 10 kapena kuposerapo, amafunika kuthandizidwa mwachangu.

Njira zopewera kupewa ngozi

Mukamayendetsa glucagon, zotsatirazi ziyenera kuganiziridwa:

• Ndi hyperglycemia, glucagon imatha kukulitsa vuto la wodwala. Zizindikiro za hyper- ndi hypoglycemia ndizofanana, motero m'pofunika kuyeza shuga musanapereke mahomoni.
• Wodwala amatha kukhala kuti sagwirizana ndi zomwe zimagwiritsidwa ntchito ndi mankhwalawa, chiopsezo chodwala anaphylactic chimawerengedwa ngati chotsika kwambiri.
• Hormoni imatha kuperekedwa pa nthawi yoyembekezera komanso HB popanda chiopsezo kwa mwana.
• Glucagon silingagwiritsidwe ntchito ndi pheochromocytoma, chifukwa izi ndizodzala ndi kuwonjezeka kowopsa kwa mavuto.
• Kukhazikitsidwa kwa mankhwalawa kungakhale kopanda pake ndikulankhula kwa indomethacin kwakanthawi. Nthawi zina, hypoglycemia imachulukirachulukira.
• Hormayo imawonjezera zochita za anticoagulants.

Pambuyo pa kukhazikitsidwa kwa glucagon, kugunda kwa mtima kungachuluke, kupanikizika kungachuluke, tachycardia yochepa ikhoza kuchitika, ndipo mseru ungayambike. Mukamamwa beta-blockers, zizindikirozi nthawi zambiri zimatchulidwa.