Kev haus cawv cov ntshav qab zib - qhov kev txhim kho rau kev txhim kho thiab yuav ua li cas thiaj li tshem tawm nws

A. Cov ncauj lus dav dav.Kev haus dej haus cawv yog qhov ua rau muaj ntshav nce siab ntau hauv cov menyuam mos thiab menyuam hlob. Tus menyuam yaus tuaj yeem haus cawv thaum yau los ntawm tus neeg laus thaum noj mov. Nyob rau hauv cov ntaub ntawv no, hypoglycemia feem ntau tshwm sim rau tag kis. Qee zaum cov niam txiv muab lawv tus menyuam npias lossis cawv.

B. Lub Neej Kev Kawm Txuj Ci. Qhov hloov pauv ntawm ethanol rau acetaldehyde yog catalyzed los ntawm cawv dehydrogenase. Lub cofactor ntawm no enzyme yog NAD - ib yam khoom tsim nyog rau gluconeogenesis. Kev noj tshuaj Ethanol ua rau kev siv nyiaj sai sai ntawm NAD thiab qhov ncauj txwv sai ntawm gluconeogenesis hauv lub siab. Ethanol ua rau cov ntshav qog ntshav qab zib tsuas yog tom qab 6-8 teev tsaus ntuj (thaum cov khoom ntawm glycogen hauv lub siab ua haujlwm tawm).

B. Kev Kho Mob. Nrog cov ntshav qog ua kom qis lossis ua kom qis, tus menyuam tau haus dej thiab zaub mov muaj qabzib ntau ntau. Kev mob ntshav qab zib tsawg yog raug tshem tawm los ntawm cov leeg ntshav vim li cas. Tom qab ib qho kev raug mob ntawm hypoglycemia, yog tias qhov tseeb ntawm kev haus dej haus tau tsim, nws tsis tas yuav kuaj tus menyuam.

Viii. Tshuaj tiv thaiv qog ntshav qab zib.Kev mob ntshav qab zib hauv menyuam yaus tuaj yeem tshwm sim los ntawm kev qhia txog cov tshuaj insulin, kev noj tshuaj rau qhov ncauj qab zib lossis kev noj tshuaj salicylates loj. Valproic acid thiab nws cov derivatives inhibit qhov oxidation ntawm fatty acids, uas ua rau cov tsis muaj peev xwm gluconeogenesis thiab carnitine tsis txaus. Kev noj tshuaj ntau dhau ntawm valproic acid thiab nws cov txiaj ntsig tuaj yeem tshwm sim nws tus kheej li hypoglycemia tsis muaj ketonemia thiab ketonuria, tshwj xeeb tshaj yog tom qab tshaib plab.

Kev tswj hwm tshuaj insulin yog ib hom kev tsim txom menyuam yaus. Nws kuj tseem tshwm sim uas cov niam txiv tau muab cov tshuaj insulin rau tus menyuam, vim nws xav tias lawv muaj ntshav qab zib insulin-tiv thaiv kev mob ntshav qab zib. Kev mob ntshav qab zib yog tshwm sim los ntawm insulin thiab kab mob hypoglycemic qhov ncauj yog feem ntau nrog kev qaug dab peg thiab tsis nco qab thiab tuaj yeem tsis meej pem nrog lwm hom hypoglycemia.

IX. Idiopathic reactive hypoglycemia - ib hom kev mob ntshav qab zib ntshav ntau uas tshwm sim los ntawm kev noj zaub mov (saib tshooj 34, p. VIII). Daim ntawv ntawm cov ntshav qog ntshav ntshav feem ntau yog xav tau hauv cov menyuam yaus thiab cov tub ntxhais hluas, tab sis kev kuaj mob feem ntau tsis tshua pom tseeb. Kev kuaj mob ntawm idiopathic reactive hypoglycemia yog tsim nyob rau hauv lub hauv paus ntawm qhov txiaj ntsig ntawm qhov ncauj ntawm qhov ncauj kam rau kuaj: 3-5 teev tom qab noj ntshav qabzib ntawm ib koob ntawm 1.75 g / kg (siab tshaj 75 g), cov ntsiab lus ntawm cov piam thaj hauv cov ntshav

Kev haus dej cawv ua rau lub ntsej muag hypoglycemic syndrome

Tus cwj pwm ntawm ethanol nyob rau hauv cov hlab ntshav yog tsis meej xwm:

• Ua ntej tshaj plaws, nws nce qhov kev ua haujlwm ntawm insulin thiab piam sij-ntsiav tshuaj txo qis.
• Ua rau mob rau daim siab, ethanol cuam tshuam qhov kev tsim cov glucogen - ib qho ntxiv los ntawm cov piam thaj.
• Lub tshuab ntawm kev txiav txim ntawm cov cawv yog zoo ib yam li cov haujlwm ntawm lipids: dissolving fats, nws nce permeability ntawm cov rog rog. Los ntawm cov pores nthuav dav ntawm cov qog ua ntshav, qabzib los ntawm cov ntshav nkag mus rau hauv lub cell. Thaum nws cov ntsiab lus nyob rau hauv lub voj voog poob qis, ib qho tseem ceeb tshaib plab tshwm sim.

Ib qho ntxiv, ethanol kho qhov ua haujlwm ntawm kev loj hlob hormone thiab cuam tshuam lub cev tsis txaus teb rau ntshav qab zib pauv. Qhov no yog ib qho ntawm feem ntau ua rau hypoglycemia hauv cov neeg quav cawv, vim tias kev loj hlob hormone tswj cov glucometer.

Ua tsaug rau qhov "npliag" "calories" uas muaj ethanol, nws inhibits kev siv lub cev rog.

Tus txheej txheem ntawm kev txhim kho ntawm cov cawv cawv cov ntshav qab zib tsawg

Tus neeg mob ntshav qab zib nrog qhov "kev paub" ntawm tus kab mob paub txog cov piam thaj hauv qab qis muaj peev xwm ntawm kev haus cawv. Cov qib piam thaj nce siab nyob hauv ob txoj kev: nrog kev nqus ntawm carbohydrates nrog zaub mov thiab los ntawm kev tsim cov glycogen los ntawm lub siab. Cov suab thaj zoo ruaj khov pab txhawb cov suab thaj kom tsawg kawg yog 3.3 mmol / L. Yog tias haus cawv txwv tsis pub gluconeogenesis los ntawm thaiv lub siab, xav txog qhov tshwm sim rau lub cev thaum cov piam thaj tsis xa tawm. Txoj kev pheej hmoo ntawm kev khwv tau qog ntshav qab zib muaj ntau dua nyob rau hauv cov ntshav qab zib muaj peev xwm tiv thaiv cov kab mob ntshav qab zib, txij li kho qhov tshuaj kom coj mus rau hauv tus saib xyuas kev haus cawv tsis yooj yim.

Ethanol ua rau lub ntsej muag hypoglycemia vim muaj kev cuam tshuam ntawm cov txheej txheem gluconeogenesis nrog kev hloov pauv ntawm cytosolic piv NAD H2 / NAD. Kev ua dej cawv hauv lub siab catalyzes cawv dehydrogenase. Lub cofactor ntawm enzyme, NAD (nicotinamide adenine dinucleotide) yog qhov tseem ceeb ntawm glucogenesis. Kev nqus dej cawv hauv cov kab mob hauv lub cev ua rau muaj kev noj cov nquag ntawm NAD thiab cov tib lub sijhawm ua haujlwm thaiv glycogen los ntawm daim siab.

Pom tseeb, cov ntshav cawv ntshav qab zib muaj peev xwm tiv thaiv keeb kwm yav dhau los ntawm qhov kev txo qis glycogen, thaum lub siab muaj peev xwm ua rau glucogenesis yog qhov tseem ceeb heev rau kev ua haujlwm ntawm cov suab thaj. Kev pheej hmoo yog cov neeg uas nquag haus cawv nrog kev noj zaub mov me me.

Kev kuaj mob ntawm lub xeev hypoglycemic

Kev haus dej cawv yog qhov yuav tsum tau ua ua ntej ua ntej rau kev txhim kho ntshav qab zib hauv qeb ntawm cov neeg raug tsim txom yam tsis paub txog tus mob ntshav qab zib mellitus. Thaum xub thawj, cov txheeb cais no tau saib xyuas los ntawm impurities uas muaj cov dej qab zib tsis muaj zog. Tab sis tom qab kev sim nrog ethanol ntshiab, uas tau muab rau cov neeg tuaj yeem noj qab haus huv tiag tiag uas yav dhau los nws tau tshaib plab rau ob lossis peb hnub thiab pom cov txiaj ntsig zoo sib xws, qhov pom ntawm no yuav tsum tau hloov.

Kev haus cawv qaug cawv feem ntau pom ntawm cov neeg nyiam haus cawv uas mus nrog nws tsis noj khoom txom ncauj rau ib hnub lossis ob hnub. Ib qho teeb meem tshwm sim hauv 6-24 teev tom qab ethanol nkag mus rau hauv cov ntshav, yog li nws yog qhov tsis tsim nyog los kuaj xyuas qhov kev tawm tsam los ntawm tsis hnov ​​tsw tawm ntawm lub qhov ncauj, yuav tsum muaj kev tshawb fawb hauv chav kuaj. Muaj keeb kwm ntawm cov tsos mob nyob rau hauv daim ntawv ntawm kev ntuav rov ua dua, qhov no qhia qhov voos ntawm lub paj hlwb thiab lub plab nrog haus cawv, muaj cov calories tsawg thaum tsuas yog cov as-ham uas muaj ethanol nkag rau hauv lub plab.

Ntawm kev pheej hmoo, raws li cov kev ntxim rau hypoglycemic lub txim ntawm kev haus cawv:

• Cov mob ntshav qab zib insulin,
• Cov neeg mob nrog pathologies ntawm lub pituitary-adrenal system,
• Cov menyuam yaus uas muaj lub sijhawm los haus dej cawv los ntawm kev sib tsoo.

Qhov phom sij ntawm qaug dab peg thiab ua rau nws tsis nco qab txog qhov muaj ntshav qab zib tsawg rau cov menyuam yaus hnub nyoog qis dua 5 xyoos. Lub koob tshuaj tso tawm cov tshuaj ethanol ntshiab rau cov menyuam yaus yog 3 g / kg (hauv cov laus - 5-8 g / kg).

Cawv-ua rau cov ntshav qis hypoglycemia feem ntau xaus rau qhov tsis xeev (coma). Nws yog qhov nyuaj kom paub qhov txawv ntawm lub xeev no los ntawm kev haus cawv tsis txaus.

Cawv hypoglycemia yog tus yam ntxwv tseem ceeb:

Kev kuaj ntshav siab qhia pom tias yog li cas, nws yog ib qho ua tau los ntsuas tus mob tsuas yog keeb kwm ntawm kev haus dej haus cawv tau sau tseg hauv anamnesis. Tom qab ua kom rov qab los ntawm cov khoom siv glycogen, kev haus cawv tsis ua rau cov ntshav qab zib tsis muaj mob.

Kev mob ntshav qab zib nrog tshuaj hauv paus muaj cawv yog koob tshuaj ntau: tus neeg raug tsim txom ntau npaum li cas, ntev dua glucogenesis yog suppressed. Ntawm kev phom sij tshwj xeeb yog daim ntawv qeeb ntawm hypoglycemia. Yog tias thaum yav tsaus ntuj nws tau haus cawv ntau, nws yuav muaj teeb meem tsaus ntuj. Vim tias muaj qhov qis tshaj plaws ntawm glycogen hauv daim siab, qhov xwm txheej no nyuaj kho. Cawv haus cawv ua rau muaj qhov tsis quav ntsej txog cov tshwm sim ntawm kev txo ntshav siab, yog li ntawd, kev ntsuas sijhawm ua kom tshem tau lawv tsis coj mus.

Yuav ua li cas txhawm rau txo cov cawv ntshav qab zib kom tsawg

Yog tias tsis muaj kev kuaj mob kom raws sijhawm thiab kev kho kom maj nrawm, kev tuag ntawm tus mob no pom muaj 25% ntawm cov menyuam yaus thiab 10% ntawm cov neeg raug mob.

Los ntawm kev qhia txog glucagon, qhov teeb meem tshwm sim los ntawm kev haus cawv tsis tuaj yeem daws, vim tias tsis muaj glycogen ntxiv, ntxiv rau lub cev lub cev tiv thaiv cov tshuaj no. Cov kua nplaum txhaj tshuaj muaj txiaj ntsig zoo los txo cov qib lactate thiab ib txwm ua haujlwm ntawm cov kua qaub-hauv qab. Tsis zoo li cov tshuaj rau hypoglycemia ntau npaum li cas, tus neeg mob tsis xav tau cov piam thaj txuas ntxiv mus. Hauv cov menyuam yaus uas muaj cov tsos mob zoo li no, lawv pib nrog cov piam thaj, thiab cov ntshav nrog kua qabzib-electrolyte tov nrog nws.

Raws li kev pabcuam thawj zaug (yog tias tus neeg raug tsim txom nco qab) nws tau tso cai siv cov khoom noj khoom haus sai sai - khoom qab zib, kua txiv qab zib. Rov qab los ntawm cov ntshav ntshav qab zib kom tsawg yog los ntawm kev tiv thaiv ntawm cov carbohydrates. Cov ntsiav tshuaj qabzib muaj cov txiaj ntsig ntawm cov carbohydrates.

Txoj hauv kev zoo tshaj kom tshem tawm hypoglycemic tsis nco qab yog tiv thaiv:

1. Tus mob ntshav qab zib xav kom haus dej haus kom tsawg.
2. Cawv tsis tuaj yeem ua txoj hauv kev txo qis glycemia.
3. Nrog lub siab ua kom noj qab haus huv, nws raug tso cai kom haus 50 g ntawm vodka thiab cognac lossis 150 mg ntawm cov cawv qhuav (cov qauv tseem ceeb rau cov dej haus yog tsis muaj piam thaj thiab tsawg kawg ntawm calories).
4. Qee lub sij hawm koj tuaj yeem haus npias - txog 300 g (qhov mob los ntawm carbohydrates yog compensated los ntawm cov txiaj ntsig ntawm brewer cov poov xab).
5. Tag nrho cov dej qab zib muaj zog yog txwv tsis pub - khoom noj qab zib thiab muaj cawv, cawv, cawv, thiab lwm yam. Rau cov poj niam cev xeeb tub, tsis muaj kev xaiv nyob rau hauv cov teeb meem no: haus cawv tsis pub ua.
6. Nco ntsoov tias dej cawv qhov ncauj qhov ntswg ua rau cov neeg mob ntshav qab zib tsawg, suav nrog kev ncua. Ceeb toom txog koj cov teeb meem rau cov neeg uas nyob rau lub sijhawm no.
7. Cov zaub mov muaj cawv yuav tsum tau noj tom qab noj mov tas.
8. Ua ntej yuav mus pw, nco ntsoov ua ib qho kev ntsuas maj mam ua rau qab zib thiab noj tej yam nrog carbohydrates.
9. Thaum xam xyuas cov calories ntawm koj cov zaub mov noj, coj mus rau hauv tus account cov calories ntau ntawm cov dej cawv: 1 g ntawm cov protein lossis carbohydrates - 4 kcal, 1 g ntawm cov rog - 9 kcal, 1 g ntawm ethanol - 7 kcal.
10. Npaj rau qhov tseeb tias cawv yuav ua rau lub zog ntawm triglycerides ntau ntxiv, txhim kho qhov tshwm sim ntawm cov tsos mob neurological hauv ntshav qab zib nephropathy.