MENE NE LACTIC ACIDOSIS KUMA YAYA YAKE DA ALAƘA DA CIWON SUKARI?

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Productionarin samarwa ko rage amfani da lactic acid yana haifar da raguwa mai mahimmanci a ma'aunin acid-base a cikin jiki. Wannan "acidification" yana tsokani mummunan yanayin cutar - lactic acidosis.

Daga ina ake samun lactate mai yawa?

Metabolism na glucose wani tsari ne mai rikitarwa, aikin wanda bawai shine kawai don daidaita jikin tare da "makamashi" ba, har ma don shiga cikin "tsarin numfashi na sel."

A ƙarƙashin tasirin mai samar da ƙwayoyin halitta, ƙwayar glucose ta bazu kuma ta samar da kwayoyin pyruvic acid guda biyu (pyruvate). Tare da isasshen oxygen, pyruvate ya zama kayan farawa don yawancin hanyoyin tafiyar matakai a cikin sel. A cikin yanayin yunwar oxygen, sai ya zama lactate. Smallarin adadin shi wajibi ne ga jiki, an mayar da lactate a cikin hanta kuma ya juya zuwa glucose. Wannan yana samar da yanayin dabarun glycogen.

A yadda aka saba, rabo na pyruvate da lactate shine 10: 1, a ƙarƙashin rinjayar abubuwan abubuwan waje, daidaituwa na iya matsawa. Akwai yanayin barazanar rayuwa - lactic acidosis.

Abubuwan da ke haifar da haɓaka taro na lactic acid sun hada da:

hypoxia na nama (girgiza mai guba, guba na carbon dioxide, matsanancin rashin ƙarfi, amai);
matsanancin rashin iskar oxygen (guba tare da methanol, cyanides, biguanides, renal / wucin gadi, oncology, cututtukan fata mai tsanani, mellitus ciwon sukari).

Babban haɓaka mai mahimmanci a cikin matakin lactic acid a cikin jiki shine yanayin da ke buƙatar gaggawa, asibiti cikin gaggawa. Har zuwa 50% na lokuta da aka gano suna da lahani!

Sanadin Ciwon Mara Lafiya Acidosis

Lactic acidosis abu ne mai saurin faruwa, tare da fiye da rabin abubuwan da aka ruwaito suna faruwa a cikin masu ciwon sukari.

Hyperglycemia yana haifar da gaskiyar cewa yawan sukari mai yawa a cikin jini yana canzawa zuwa lactic acid. Rashin insulin yana shafar juyawa da pyruvate - rashi mai haɓaka na halitta yana haifar da karuwa a cikin aikin lactate. Kwayar cuta mai ɗorewa tana taimakawa matsanancin rashin ƙarfi na sel, yana tattare da rikitarwa da yawa (kodan, hanta, tsarin zuciya) wanda ke haifar da matsananciyar yunwar oxygen.

Babban adadin abin da ke haifar da lactic acidosis yana faruwa ne a cikin mutanen da ke shan magungunan maganin cututtukan ƙwayoyi. Biguanides na zamani (metformin) ba sa haifar da ci gaba mai tarin yawa na lactic acid a cikin jiki, kodayake, idan abubuwanda suka haifar da yawa (cutar, rauni, guba, shan giya, yawan motsa jiki) yana faruwa, zasu iya ba da gudummawa ga yanayin cutar.

Bayyanar cututtuka na lactic acidosis a cikin ciwon sukari

Gabaɗayan hoton bayyanar iri ɗaya ne kamar na sukarin jini

Ana lura da rauni, rauni, gajiya, yawan damuwa a cikin gabar jiki, tashin zuciya, karancin lokaci na iya faruwa. Lactic acidosis yana da haɗari saboda yana tasowa da sauri cikin fewan awanni kaɗan. Bayan bayyanar cututtuka na yau da kullun, zawo, amai, da rikicewa suna tasowa kwatsam. A lokaci guda, babu jikin ketone a cikin fitsari, babu kamshin acetone.

Lactic acid coma shine ɗayan haɗari mafi hatsari, tsinkayar wata hanyar daga cikinta babu matsala!

Idan tsararrakin gwaji na ƙudurin gani na ketoacidosis da matakin glucose yana nuna yawan sukari mai yawa, yayin da akwai raunin tsoka, ya kamata ku kira motar asibiti nan da nan! Idan baku dauki wani mataki ba kuma kuyi kokarin dakatar da yanayin da kanku, to kuwa raguwar karfin jini, da wuya, da yawan shan iska, rikicewar bugun zuciya, wata cuta ce zata biyo baya.

Babban bambanci tsakanin lactic acidosis da ketoacidosis ko hyperglycemia mai zafi shine kasancewar jin zafi a cikin tsokoki, wanda yawanci idan aka kwatanta shi da ƙyalli na 'yan wasa.

Hyperlactatacidemia Jiyya

Bayyanar cututtuka na lactic acidosis ne kawai za'a iya yi tare da gwaje-gwaje na dakin gwaje-gwaje. Da farko dai, suna kokarin bambance acidosis. Matsayi matakan lactate daga 5.0 mmol / L kuma ph kasa da 7.25 yana ba ku damar amincewa da binciken guba na lactic acid na jiki. Matsayi mai acid-base a ƙasa 6.8 yana da mahimmanci.

Jiyya ta ƙunshi sake dawo da ma'aunin acid-base, kawar da abubuwan Sanadin cutar hauka

Idan ph yana da ƙasa da 7.0, hanya ɗaya don ceton mai haƙuri ita ce hemodialysis - tsarkake jini.
Don kawar da wuce haddi CO2, zazzabin huhun sankara a cikin huhu.
A cikin ƙananan milder, tare da isa ga kwararru na lokaci, digo tare da maganin alkaline (sodium bicarbonate, trisamine) ya isa. Adadin gudanarwa ya dogara da matsin lamba na tsakiya. Da zarar an inganta aikin ku, za ku iya fara rage matakin lactate na jini. Don wannan, ana iya amfani da dabaru daban-daban don gudanar da maganin glucose tare da insulin. A matsayinka na mai mulkin, wannan raka'a 2-8 ne. tare da saurin 100-250 ml / h.
Idan mai haƙuri yana da wasu abubuwan da ke da alaƙa da lactic acidosis (guba, anemia), ana gudanar da jiyyarsu bisa ga ka'ida ta gargajiya.

Zai iya yiwuwa ba da taimakon farko ga alamun lactic acidosis. Don rage acidity na jini a waje da asibiti ba zaiyi aiki ba. Ruwan ma'adinai na ruwa da maganin soda ba zai haifar da sakamakon da ake so ba. Tare da rage karfin jini ko girgizawa, yin amfani da dopamine barata ne. Wajibi ne a tabbatar da matsakaicin iska, yayin rashin matashin iskar oxygen ko inhaler, zaku iya kunna humidifier kuma ku buɗe dukkanin windows.

Tsinkaya don farfadowa daga lactic acidosis bashi da kyau. Ko da isasshen magani da isa ga likitoci bai bada tabbacin ceton rai ba. Sabili da haka, masu ciwon sukari, musamman waɗanda ke shan metformin, ya kamata su saurara da kyau a jikinsu kuma su kiyaye matakan sukarinsu a cikin manufa.

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