Glycated hemoglobin pakuwona matenda a shuga

Kutha kulipirira matenda a kagayidwe kazakudya ndiko njira yokhayo yoteteza kulumala ndi kufa kwa odwala matenda ashuga. Chiwopsezo chokhala ndi angiopathies mkati mwa glycemic yambiri chatsimikiziridwa kale. Mlingo wolipiriridwa kwa "matenda okoma" ungathe kuwerengeka pokhapokha poyerekeza kuchuluka kwa hemoglobin (HbA1c). Pafupipafupi wazidziwitso umakhala mpaka kanayi pachaka.

Glycated hemoglobin imatchedwa chisonyezero cha magazi amomwe amodzi amodzi amodzi omwe amawonetsa kuchuluka kwa shuga kwa kotala lotsiriza. Ndi nthawi yoti zotsatira zitha kuwerengedwa ndikuwunika kofunikira pofufuza, mosiyana ndi kuwunika komwe kumachitika, pomwe chizindikirocho chimalumikizidwa ndi nthawi yakumwa zitsanzo. Kukula kwa hemoglobin wa glycated mu shuga mellitus ndi kutanthauzira kwa zotsatirazi kwatchulidwa m'nkhaniyi.

Mawonekedwe Ozindikira

Maselo ofiira amakhala ndi hemoglobin A. Ndiye amene, akaphatikizana ndi glucose ndikuchita zotsatizana zosiyanasiyana zamankhwala, amakhala glycosylated hemoglobin. Kuthamanga kwa "kutembenuka" kumeneku kumadalira kuchuluka kwa shuga mu nthawi yomwe maselo ofiira amoyo ali moyo. Nthawi yokhala ndi maselo ofiira a m'magazi mpaka masiku 120. Ndi munthawi imeneyi kuti manambala a HbA1c amawerengedwa, koma nthawi zina, kuti athe kupeza zotsatira zolondola kwambiri, amalingalira theka la moyo wam'magazi ofiira - masiku 60.

Mitundu yotsatirayi ya glycosylated hemoglobin ndi:

• HbA1a;
• HbA1b;
• HbA1c.

Malinga ndi ziwerengero, kuchuluka kwa mayeso a chizindikirochi sikupitirira 10% ya zochitika zonse zamankhwala, sizowona ngati zikuvomerezeka. Ichi ndichifukwa chosazindikira zambiri za odwalawa za kufunikira kwa kusanthula, kugwiritsa ntchito kwa osanthula osunthika omwe ali ndi zotsatira zochepa komanso kuchuluka kwakanapezeke m'malo ena, komwe kumakulitsa kusakhulupirika kwa akatswiri pakuyesa.

Hyperglycemia - Mgwirizano Wapakati Wokulitsa HbA1c Milingo

Ndani anapatsidwa kuwunikaku?

Kuwongolera sikofunikira osati kwa odwala matenda ashuga okha, komanso kwa anthu athanzi omwe amakonda kunenepa kwambiri komanso matenda oopsa. Kuzindikira pafupipafupi kukuwonekera pazochitika zotsatirazi:

• kwa anthu onse atatha zaka 45 (zaka 2-3 zilizonse, ngati zotsatira zoyambirira zinali zabwinobwino);
• odwala omwe ali ndi abale omwe akudwala matenda a shuga;
• anthu okhala ndi moyo wongokhala;
• omwe ali ndi kulolera kwa glucose;
• azimayi omwe ali ndi mbiri yodwala matenda ashuga;
• azimayi omwe adabereka mwana yemwe ali ndi mbiri ya macrosomia;
• odwala polycystic ovary syndrome;
• odwala matenda a shuga mellitus (woyamba kuzindikiridwa motsutsana ndi maziko azomwe zimachitika zovuta);
• ndi ma pathologies ena (omwe ali ndi matenda a Itsenko-Cushing, acromegaly, thyrotooticosis, aldosteroma).

Kukonzekera kusonkhanitsa kwa zinthu sikofunikira. Kuyesedwa kwa kudziwa kwa glycosylated hemoglobin sikuti kwa ana osakwana miyezi 6.

Magazi a Venous - zothandizira kuzindikira milingo ya HbA1c

Maubwino Ozindikira

Zatsimikiziridwa mwachipatala kuti kufufuza pafupipafupi kwa odwala omwe ali ndi matenda a shuga kumachepetsa zovuta, chifukwa zimatha kuyang'ana ndikusintha chindapusa.

Ndi mawonekedwe odalira insulini, chiopsezo cha retinopathy chimachepetsedwa ndi 25-30%, polyneuropathy - ndi 35-40%, nephropathy - mwa 30-35%. Ndi mawonekedwe odziyimira pawokha a insulin, chiopsezo chokhala ndi matenda osiyanasiyana a angiopathy amachepetsedwa ndi 30-35%, zotsatira zakupha chifukwa cha zovuta za "matenda okoma" - mwa 25-30%, kuphwanya myocardial - mwa 10-15%, ndi kufa kwathunthu - mwa 3-5%. Kuphatikiza apo, kuwunika kumatha kuchitika nthawi iliyonse, mosasamala kanthu za kudya. Matenda oyipa samakhudza mayendedwe a kafukufukuyu.

Zizindikiro zodziwika bwino m'magazi

Zotsatira zakuzindikira pa labotale yopanda kanthu zalembedwa mu%. Makhalidwe azikhalidwe wamba ndi azitsamba ndi awa:

• mpaka 5.7 - ikuwonetsa kagayidwe kake, sikutanthauza njira zowonjezera;
• Pamwambapa 5.7, koma pansipa 6.0 - palibe "matenda okoma", koma kuwongolera zakudya ndikofunikira, popeza chiwopsezo cha kukulitsa matenda a m'mimba ndi chambiri;
• pamwambapa 6.0, koma pansipa 6.5 - mkhalidwe wa prediabetes kapena kulolera shuga;
• 6, 5 ndi pamwamba - kudziwika kwa matenda a shuga ndikukaikira.

Makonda a HbA1c ndi mitengo ya shuga wamba

Zowonetsa za Ndalama

Kuzindikira mphamvu ya mankhwala a mtundu 1 matenda a shuga monga glycated hemoglobin:

• pansipa 6.1 - palibe matenda;
• 6.1-7.5 - chithandizo ndi chothandiza;
• Pamwambapa 7.5 - kusowa kwa chithandizo chamankhwala.

Malangizo pofotokozera za matenda amtundu 1 ndi mtundu wachiwiri:

• pansipa 7 - kubwezerera (chizolowezi);
• 7.1-7.5 - zopereka;
• pamwambapa 7.5 - kubwezeretsa.

Chiwopsezo chotenga angiopathies motsutsana ndi mtundu wa matenda ashuga amtundu wa 2 malinga ndi zonena za HbA1c:

• mpaka ndikuphatikizapo 6.5 - chiopsezo chochepa;
• pamwambapa 6.5 - chiwopsezo chachikulu chotukula macroangiopathies;
• Pamwambapa 7.5 - chiwopsezo chachikulu chotukula micangiopathies.

Sinthani pafupipafupi

Laboratory matenda a mtundu 1 shuga

Ngati matenda a shuga adapezeka koyamba, odwala otere amapezeka kamodzi pachaka. Ndi pafupipafupi momwemo, iwo omwe sagwiritsa ntchito mankhwalawa chifukwa cha "matenda okoma", koma kufunafuna chiphuphu ndi chithandizo cha zakudya komanso zolimbitsa thupi zolimbitsa thupi, amayeza.

Pankhani yogwiritsa ntchito othandizira a hypoglycemic, kulipira bwino kumafunikira kuyang'ana zizindikiro za HbA1c kamodzi pachaka, ndi kubwezeredwa koyipa - kamodzi pa miyezi 6. Ngati adotolo adakonzera kukonzekera kwa insulin, ndiye kuti kuwunikirako ngati chithandiziro chabwino kumachitika kuyambira 2 mpaka 4 pachaka, osakwanira - 4 times pachaka.

Zofunika! Kupitilira kanthawi 4 kuti mudziwe kuti zili bwino sizikumveka.

Zoyambitsa kusinthasintha

Kuchuluka kwa hemoglobin wa glycosylated kumatha kuonedwa osati ndi "matenda okoma", komanso motsutsana ndi maziko azikhalidwe zotsatirazi:

• high fetal hemoglobin mu akhanda (mkhalidwe ndi zokhudza thupi ndipo safuna kuwongolera);
• kutsika kwa kuchuluka kwa chitsulo mthupi;
• motsutsana ndi maziko a opaleshoni yochotsa ndulu.

Kuchepetsa kapena kuchuluka kwa zizindikiro - nthawi yoti awongolere

Kutsika kwa HbA1c kumachitika mu milandu yotere:

• kukulitsa kwa hypoglycemia (kuchepa kwa shuga wamagazi);
• kuchuluka kwa hemoglobin wabwinobwino;
• chikhalidwe pambuyo magazi, pamene hematopoietic dongosolo adayambitsa;
• hemolytic anemia;
• kukhalapo kwa zotupa ndi magazi a pachimake kapena matenda chikhalidwe;
• kulephera kwa impso;
• kuthira magazi.

Njira Zozindikira ndi Openda

Pali njira zingapo zomwe zimagwiritsidwa ntchito kuti zidziwike mawonekedwe a glycated hemoglobin; motero, pali angapo omwe amasanthula mwanjira iliyonse yodziwira matenda.

HPLC

Kupsinjika kwakukulu kwa ion chromatography ndi njira yolekanitsa chinthu chovuta kukhala tinthu tating'ono, komwe sing'anga yayikulu ndi madzi. Gwiritsani ntchito owerenga a D 10 ndi Variant II. Kuyesaku kumachitika ndi m'magulu azachipatala a zigawo zam'mizinda ndi zamzindawo, malo owerengera anthu odwala. Njira ndi yotsimikizika kwathunthu komanso yodziwikiratu. Zotsatira za kuzindikira sizifuna kutsimikizika kowonjezereka.

Osamayama

Njira yowunikira yozikidwa pa pulogalamu yakale ya antigen-antibody. Kuphatikizika kwa kuphatikizika kumalola mapangidwe a maofesi omwe, akaphatikizidwa ndi zinthu zowunikira, amatha kutsimikiza pansi pa chithunzi. Pakufufuza, seramu yamagazi imagwiritsidwa ntchito, komanso zida zapadera za diagnostic pa biochemical analysis.

Openda ozama kwambiri amomwe amathandizira pakuwunika - kuthekera kwa kudziwikitsa kwambiri

Kafukufuku wamtunduwu akuchitika mu labothem yamankhwala opangidwa ndi ma biochemical ndi kuyeza kwapakati kapena kotsika. Choyipa cha njirayi ndikufunika kukonzekera kwachitsanzo.

Chiyanjano chokomera

Njira yofufuzira mwachindunji yokhudzana ndi kuyenderana kwa mapuloteni omwe ali ndi zinthu zina zachilengedwe zomwe zimawonjezeranso chilengedwe. Openda mayesowo - In2it, NycoCard. Njira imakuthandizani kuti muzindikire mwachindunji muofesi ya dokotala (wogwiritsidwa ntchito m'maiko aku Europe).

Chiyeso chimagwiritsidwa ntchito pazinthu zokhazokha, zimakhala ndi mtengo wokwanira wowonjezera, chifukwa chake sizofala kugwiritsa ntchito. Kutanthauzira kwa zotsatira kumachitika ndi dotolo yemwe wakupatsani phunzirolo. Kutengera ndi zomwe zidapezeka, njira zina zowongolera odwala zimasankhidwa.