Acidosis motsi ne a cikin acid - ma'aunin tushe don haɓaka acidity. Wannan ya faru ne sakamakon tara kwayoyin acid a cikin jini.
Acidosis a cikin ciwon sukari sau da yawa yana faruwa tare da tarin jikin ketone - ketoacidosis. Hakanan, tare da karuwa a cikin taro na lactic acid a cikin jini, lactic acidosis na iya faruwa.
Dukkan nau'ikan biyu suna haɓaka tare da hanya mai lalatarwa da ciwon sukari kuma suna buƙatar asibiti cikin gaggawa, tun da karuwa da alamun acidosis yana haifar da ci gaba.
Sanadin ketoacidosis a cikin ciwon sukari
Tare da karancin insulin a cikin sel, alamomin yunwa na tasowa saboda karancin glucose. Don makamashi, jiki yana fara amfani da shagunan mai. Fats, lokacin da aka rushe, suna samar da jikin ketone - acetone, acetoacetic da beta-hydroxybutyric acid.
Ketones daga jini an fesa a cikin fitsari, amma idan sun yi yawa suna yawa, to kodan ba za su iya jure nauyin ba sannan kuma yawan jinin ya hau. Ciwon sukari acidosis na iya wahalar da cutar ba tare da magani ba:
- Tsallake allurar insulin.
- Rashin izini na magani.
- Dosearancin ƙwayar insulin a cikin rashin sarrafa glucose a cikin jini.
- Amincewa da ɗumbin ɗumbin abinci mai daɗi ko gari, tsallake abinci.
- Insulin ya ƙare ko ajiyar magungunan.
- Alkalami mai sarkakiya ko famfo.
- Atearshe takardar maganin insulin don maganin ciwon sukari na 2 wanda aka nuna
A cikin cututtukan cututtukan m, ayyukan tiyata, musamman a kan pancreas, raunin da ya faru, ƙonewa mai yawa kuma yayin daukar ciki, ana buƙatar daidaita sashin insulin, idan ba a yi hakan ba, to, haɗarin ketoacidotic coma yana ƙaruwa.
Ketoacidosis na iya faruwa tare da yin amfani da glucocorticosteroids, diuretics, hormones na jima'i, kwayoyin cuta, rigakafi, rigakafi. Rashin sakamako na zazzabi a cikin nau'in sanyi ko zafin jiki, zubar jini, bugun zuciya da bugun jini na iya haifar da haɓakar glucose na jini da ƙarin insulin don rama.
Tare da tsawan lokaci na nau'in ciwon sukari na 2, raguwar narkewar insulin, yana buƙatar sauyawa zuwa ilimin insulin.
Ketoacidosis na iya kasancewa farkon bayyanuwar cutar sankara 1.
Bayyanar cututtuka da magani na ketoacidosis
Acidosis da ke tattare da tarawar sassan ketone yana haɓaka ci gaba a cikin kwanaki da yawa, wani lokacin ana iya rage wannan tazara zuwa awanni 12-18.
Da farko, alamun da ke da alaƙa da haɓakar glucose na jini sun bayyana: ƙaruwar ƙishi, yawan zafin jiki da tsananin kauri, bushewar fata, rauni mai ƙarfi, ciwon kai da farin ciki, rage yawan ci da bacci, da kuma ƙarfin nutsuwa na acetone. Waɗannan alamun alamun ketoacidosis ne mai laushi.
Tare da ci gaban aiki na jikin ketone, anausewa da amai, wari mai ƙarfi na acetone yana fitowa daga bakin, numfashi ya zama mai santsi da zurfi. Jikin Ketone suna da guba a cikin kwakwalwa, don haka marassa lafiya suna zama masu bacci, haushi, ciwon kai, ruɗewa, ɗalibai suna amsawa ga haske kuma ƙarancin zuciya yana zama sau da yawa.
Acids suna haushi da mucous membranes na ciki da ciki, don haka akwai raunin ciki da tashin hankali a bangon ciki, masu kama da alamu na wani mummunan kumburi ko ciwon ciki. A lokaci guda, aikin motsa jiki na hanji yana rauni.
Hawan jini ya fara raguwa, fitar fitsari yayi saurin sauka. Wannan hoton na asibiti ya dace da tsananin zafin ketoacidosis mai saurin kamuwa da cuta.
Tare da karuwa a cikin ketoacidosis, alamun precoma sun bayyana:
- Rashin Ingancin magana.
- Fitsari: bushewar fata da membranes, idan aka matsa a kan gira, to suna da laushi.
- Ppuntar da raɗaɗin ɗalibai, ɗalibai sun zama kunkuntar.
- Tsammani na numfashi.
- Namijin yana kara girma.
- Cramps.
- Eyearfin ido mai motsawa.
- Rashin sanin yakamata a cikin nau'in nutsuwa, hallucinations ko disorientation.
A farkon alamar ketoacidosis, an nuna asibiti mai gaggawa. Don tabbatar da ganewar asali, ana gudanar da nazarin taro na glucose (yana iya ƙaruwa zuwa 20 - 30 mmol / l), pH, da jikin ketone a cikin jini.
Bugu da ƙari, ana tantance kasancewar ketones a cikin fitsari da abubuwan da ke tattare da sinadarin bicarbonates a cikin ƙwayoyin, kuma ana tantance sodium da potassium a cikin jini, urea da creatinine. Don keɓance lactic acidosis, ana duba matakin lactic acid a cikin jini.
Ana magance Ketoacidosis tare da insulin, kuma ana bincika matakan glucose na jini a kowace awa; gudanar da aikin kwantar da hankali na potassium da magungunan sodium bicarbonate da cike gurbi na raunin jini.
Ana magance cututtukan da ke haifar da cututtukan acidosis.
Lactic acidosis a cikin ciwon sukari
Rarraba ƙwayoyin lactic acid a cikin jini, wanda ya wuce matakin 5 mmol / l, yana haifar da karuwa cikin acidity na jini. Wannan yanayin yana tasowa idan an haɓaka samuwar lactate, kuma ana rage aikin hanta da haɓakar koda.
Lactic acid ana yin shi ta sel jini, tsoka nama, ƙuƙwalwar ƙodan, ƙirin mucous na ƙananan hanji, har da kyallen tumbi. A cikin hanta, ana canza lactate zuwa glucose ko amfani dashi a cikin sake zagayowar Krebs (sauya citric acid).
Matsayi na lactic acid na iya haɓaka tare da yawan wuce haddi na carbohydrates, damuwa na psychoemotional, maye giya, tare da damuwa ta jiki ko ciwo mai narkewa.
A cikin mummunan cututtuka na zuciya da jijiyoyin jini, mummunan lactic acidosis yana tasowa. Zai iya kasancewa tare da irin wannan cutar:
- Cutar numfashi wahala.
- Zuciyar zuciya.
- Rashin daidaituwa a cikin ƙwayar angina pectoris, myocarditis, cardiomyopathy.
- Rashin jini da rashin ruwa a jiki tare da haɓakar coagulation na ciki
- Tare da sepsis.
- Oncological cututtuka.
Acidosis tare da tarawa na lactate na iya haifar da guba tare da methanol, alli chloride, coma na kowane asali. Magungunan ƙwayar sukari daga rukunin biguanide (Metformin 850 ko Fenformin) suna hana samuwar glucose a cikin hanta daga lactate, don haka lactic acidosis na iya zama rikitarwa a cikin maganin ciwon sukari.
Lactic acid a cikin babban taro shine mai guba ga tsarin juyayi na tsakiya. Sabili da haka, tare da haɓakar acidosis, ɓacin rai na hankali, gazawar numfashi da kuma aiki da tsarin jijiyoyin jini. Kwayar cututtukan cututtukan cututtukan lactic acidosis yawanci ba su bambanta da bambancin ketoacidotic. Abinda kawai ya rage shine raguwar hauhawar jini da haɓaka yanayin girgizawa.
Don ganewar asali na lactic acidosis, ana nuna su ta hanyar alamun pH na jini - raguwa fiye da 7.3 mmol / L, rashi na bicarbonate a cikin jini, karuwa a cikin matakin lactic acid.
Ana aiwatar da maganin Acidosis a cikin yanayin ƙara yawan lactate ta hanyar gudanarwa mai yawa na gishirin sodium bicarbonate, allurar lipoic acid da carnitine.
Lokacin rubuta insulin, suna nuna su ta hanyar nuna alamar glucose jini.
Idan ya fi 13.9 mmol / l, to, ko da a cikin rashi na ketoacidosis, ana nuna marasa lafiya insulin a cikin ƙananan allurai.
Cutar Ciwon Acidosis
Don rigakafin rikice-rikice na ciwon sukari, dole ne a kiyaye waɗannan ƙa'idodi masu zuwa:
- Abincin tare da ƙuntatawa abinci wanda ke haifar da hauhawar hauhawar sukari jini - abinci mai sukari da farin kayan farin gari, bin dokar sha.
- Abinci ta awa, yin la'akari da allurar insulin.
- Harkokin insulin da ke gudana ta hanyar glucose jini.
- Canza kashi na magungunan rigakafi tare da bayyanar cututtuka, raunin da ya faru, hanyoyin tiyata, da ciki.
- Canza lokaci zuwa insulin a cikin nau'in ciwon sukari na 2.
- Binciken yau da kullun na endocrinologist da gwajin jini na biochemical don haemoglobin glycated, cholesterol da metabolism na lipid, renal da hepatic hadaddun.
- Nemi taimakon likita na gaggawa a farkon alamun ko ake zargin acidosis.
Bidiyo a cikin wannan labarin zai ci gaba da magana game da rikice-rikice na ciwon sukari.
