Matenda a shuga amayamba kupezeka mwa anthu kwa nthawi yayitali. Munthawi imeneyi, mankhwala adatha kuphunzira bwino matendawa, chifukwa cha zidziwitso zomwe adalandira, tsopano dokotala aliyense amatha kuzindikira bwino matendawa.
Chifukwa cha pathophysiology ya matenda ashuga, akatswiri amvetsetsa zimango zake ndipo amazindikira chithandizo chokwanira kwambiri.
Pathological physiology: ndi chiyani?
Pathological physiology ndi sayansi yomwe cholinga chake ndikuphunzira moyo wa munthu wodwala kapena chinyama.
Cholinga chachikulu cha ulendowu ndikuphunzira momwe mungapangire chitukuko cha matenda osiyanasiyana ndi njira yakuchiritsira, komanso kudziwa malamulo akuluakulu othandizira pamagulu osiyanasiyana ndi ziwalo za odwala.
Zomwe kafukufuku wamaphunziro a matenda:
- kukhazikitsidwa kwa njira zosiyanasiyana za pathological, komanso zotulukapo;
- mitundu ya matenda;
- chikhalidwe cha kukula kwa ntchito zolimbitsa thupi kutengera mkhalidwe wamthupi la munthu wokhala ndi ma pathologies osiyanasiyana.
Pathophysiology ya matenda ashuga
Mtundu 1
Amadziwika kuti makina a pathophysiological pakupanga mtundu wa matenda a shuga I amachokera ku insulin yaying'ono yomwe imapangidwa ndi maselo a endocrine.
Matenda a shuga amapezeka mu gawo lino mwa 5-10% ya odwala, atatha, popanda chithandizo chofunikira, amayamba kupita patsogolo ndipo amakhala chifukwa chazovuta zambiri, kuphatikiza:
- matenda ashuga;
- kulephera kwaimpso;
- ketoacidosis;
- matenda ashuga retinopathy;
- sitiroko;
- zilonda zam'mimba za shuga.
Chifukwa cha kuperewera kwa insulin, minofu yodalira timadzi timene timataya shuga, izi zimabweretsa ku hyperglycemia, chomwe ndi chimodzi mwazinthu zazikulu za matenda a shuga 1.
Chifukwa cha kupezeka kwa njirayi mu adipose minofu, lipids imasweka, yomwe imakhala chifukwa chowonjezera gawo lawo, ndipo njira yothetsera kuwonongeka kwa mapuloteni imayambira minofu minofu, zomwe zimapangitsa kuti ayambe kudya ma amino acid.
Mitundu iwiri
Matenda a shuga a Type II amatha kudziwika ndi kuperewera kwa insulin, komwe kumatha kukhala ndi mitundu itatu yamatenda:
- chodabwitsa cha insulin kukana. Pali kuphwanya kukhazikitsa zotsatira za insulin, pomwe ma cell a β amasungidwa ndipo amatha kupanga insulin yokwanira;
- chinsinsi cha β-cell kusowa. Kuphwanya kumeneku ndi vuto la chibadwa lomwe ma β maselo saphwanya, koma katulutsidwe ka insulin kamachepetsedwa kwambiri;
- zotsatira za zotsutsana.
Kupezeka kwa kukana kwa insulin kumatha kuchitika pa receptor ndi postreceptor.
Njira zolandirira ndi monga:
- kuwonongeka kwa ma receptors mwa ma radicals aulere ndi ma enzymes a lysosome;
- blockade of insulin receptors ndi ma antibodies omwe amatsata mawonekedwe ake;
- kusintha kwa mapangidwe a insulin receptors chifukwa cha kuwonongeka kwa jini;
- kuchepa kwa chidwi cha maselo olimbana ndi insulini kumachitika chifukwa cha kuchuluka kosakwanira kwa insulin m'magazi mwa anthu omwe amadya mopitirira muyeso;
- kusintha kwa mapangidwe a insulin receptors chifukwa cha chilema mu majini omwe amayang'anira kapangidwe ka polypeptides awo.
Njira zopangira postreceptor zimaphatikizapo:
- kuphwanya intracellular njira yochotsa shuga;
- kusakwanira kwa transmembrane glucose onyamula. Izi zimawonedwa makamaka mwa anthu onenepa kwambiri.
Matenda Asemva
Odwala matenda ashuga ayenera kuwunika bwino momwe alili, kunyalanyaza malangizo a dokotala kumabweretsa zovuta zingapo:
- zovuta pachimake. Izi zimaphatikizapo ketoacidosis (kuchuluka kwa matupi owopsa a ketone m'thupi), hyperosmolar (shuga wambiri ndi sodium mu plasma) ndi lacticidotic (ndende ya lactic acid m'magazi) chikomokere, hypoglycemia (kuchepa kwakukulu kwa shuga wamagazi);
- zovuta zovutaine. Kuwonekera, monga lamulo, patatha zaka 10-15 kukhalapo kwa matendawa. Mosasamala kanthu za momwe amathandizidwira, shuga imakhudza thupi, zomwe zimayambitsa zovuta, ziwalo zotere zimavutika: impso (kusokonezeka ndi kusakwanira), mitsempha yamagazi (kuvomerezeka kwakanthawi, komwe kumasokoneza kudya zakudya zopindulitsa ndi mpweya), khungu (magazi ochepa, zilonda zam'mimba). ), dongosolo lamanjenje (kuchepa kwa kumverera, kufooka kosalekeza ndi kupweteka);
- zovuta mochedwa. Zotsatira zotere nthawi zambiri zimayamba pang'onopang'ono, koma izi zimakhala zovulaza kwa odwala matenda ashuga. Pakati pawo: angiopathy (kusokonekera kwa mitsempha yamagazi), phazi la matenda ashuga (zilonda zam'mimba ndi zotupa zina zam'munsi), retinopathy (kufinya kwa retina), polyneuropathy (kusowa kwa chidwi ndi manja ndi mapazi kutentha ndi kupweteka).
Njira za patathophysiological zochizira matenda a shuga
Pochiza matenda amtundu uliwonse a shuga, madokotala amagwiritsa ntchito mfundo zitatu izi:
- chithandizo cha hypoglycemic;
- maphunziro a odwala;
- chakudya.
Chifukwa chake, ndi mtundu woyamba, chithandizo cha insulin chimagwiritsidwa ntchito, popeza odwalawa amakumana ndi kuperewera konse, ndipo amafunikira cholowa m'malo. Cholinga chake chachikulu ndikukulitsa kutsanzira kwa mahomoni achilengedwe.
Mlingo wokhawo uyenera kutsimikiziridwa ndi dokotala wopita kwa wodwala aliyense payekhapayekha. Pankhani ya odwala matenda ashuga amtundu wa 2, mankhwalawa amagwiritsidwa ntchito omwe amachepetsa shuga ya magazi poyambitsa kapamba.
Lamulo lofunika la chithandizo cha matendawa ndi lingaliro lolondola la wodwalayo kwa iye. Madokotala amatha nthawi yayitali kuphunzira njira yoyenera yokhalira ndi matenda ashuga.
Zakudya zimasinthidwa kwambiri, zizolowezi zoyipa ndi kupsinjika kumachotsedwa, zolimbitsa thupi zolimbitsa thupi zimawonjezeredwa, wodwala amafunikiranso kuyang'anira chizindikiro cha shuga (pali glucometer pazomwezi).
Mwina, odwala amazolowera zakudya zapadera (tebulo No. 9) kwa nthawi yayitali.
Zimafunika kuphatikizidwa kwa zinthu zambiri, kapena zina. Mwachitsanzo, nyama zamafuta, nsomba ndi ma broth, makeke ndi maswiti, tchizi chokoleti, zonona, tchizi zamchere, batala, pasitala, semolina, mpunga woyera, zipatso zotsekemera, zakudya zamzitini (kuphatikiza zamasamba zamzitini), misuzi shuga wambiri.
Zakudya zina zimatha kudyedwa, koma muyenera kuwunika kuchuluka kwa zopatsa mphamvu zomwe zimadyedwa patsiku, komanso kuchuluka kwa chakudya - sikuyenera kukhala zochuluka za izo.
Makanema okhudzana nawo
About the pathophysiology ofabetes mu kanema:
Psychology yokhudza matenda a shuga imakupatsani mwayi wodziwa za maphunzirowa ndi chithandizo cha matendawa. Mu mtundu woyamba ndi wachiwiri, ndizosiyana.
