Ntshav qab zib - lub teeb meem ntawm metabolic

Kev tsis raug lossis qhov tsis txaus ntseeg ntawm insulin (thawj qhov teeb meem ntawm cov khoom noj hauv ntshav qab zib) ua rau kev ua txhaum ntawm txhua hom metabolism, thiab, tag nrho cov, carbohydrate:

nce gluconeogenesis vim yog qhov poob ntawm qhov kev ntxim ntawm cov tshuaj insulin rau cov ntsiab lus tseem ceeb gluconeogenesis enzymes,

nce glycogenolysis nyob rau hauv kev cuam tshuam ntawm glucagon, nce gluconeogenesis thiab glycogenolysis tsim ib qho dhau ntawm cov piam thaj hauv cov ntshav, thiab

nws hloov mus rau ntawm daim nyias nyias hauv cov kab mob insulin yog qhov tsis muaj zog vim tsis muaj cov tshuaj insulin.

Yog li, peculiar qhov xwm txheejthaum lub cev muaj kev tshaib kev nqhis lub zog nrog rau cov ntsiab lus ntau ntawm lub zog nyob hauv cov ntshav.

Hyperglycemia - lub cim tseem ceeb ntawm ntshav qab zib - nce ntxiv ntshav osmolaritythiab ua raulub cev qhuav dejCov. Sai li sai tau lub qog rov qab rau cov piam thaj (8-10 mmol / L) ntau dua, nws pom nyob hauv cov zis, ua rau mobglucosuriathiabpolyuria(cov tsos mob ntawm DM decompensation). Polyuria cuam tshuam nrog kev tsis txaus reabsorption ntawm cov dej thiab electrolytes vim lub siab osmolarity ntawm thawj cov zis. Cov mob polyuria thiab hyperosmia ua raukev nqhis dejthiabpolydipsiali qubhmo ntuj(cov tsos mob ntawm DM decompensation).

Osmotic diuresis ua rau hnyav tag nrho lub cev qhuav dejthiabdyselectrolytemiaCov. Qhov tshwm sim ntawm lub cev qhuav dej yogtshuaj hypovolemia, txo cov ntshav siab, qis zuj zus ntawm lub hlwb, lub raum, poob siab pom,oliguria(txog kev txhim kho ntawm lub raum tsis ua haujlwm). Ntxiv rau, vim lub cev qhuav dej, ua kom cov ntshav tawm tuaj, sludge, ICE nthuav dav, thiab microcirculation teeb meem ua rauhypoxiacov ntaub so ntswg.

Hyperglycemia tseem ua rau kev ua kom rov qab ua dua voj voog polyol(ntawm kev ua haujlwm ntawm aldoreductase). Nws yog ib qho insulin-ywj siab cov piam thaj metabolism nrog kev tsim cov sorbitol thiab fructose. Cov khoom lag luam no tso rau hauv cov ntaub so ntswg tsis yog-insulin (lens, cov hlab ntaws, cov qe ntshav, cov ntshav liab, cov hlab ntsha, cov kab mob hauv lub cev) thiab ua rau osmotic, nyiam dej, uas ua rau kev puas tsuaj rau cov ntaub so ntswg no.

Hyperglycemia los ntawm kev tsub zuj zuj ntawm sorbitol (thiab, yog li ntawd, depletion ntawm NADPH tshwj tseg₂), thiab tseem vim tias qhov txo qis hauv kev ua ntawm protein kinase C, ua rau kev txo qis hauv kev ua kenitric oxide (endothelial so yam), uas ua rau vasoconstriction thiab nqaij ischemia,

Hyperglycemia tseem ua rau hyalinosisthiab tuab ntawm phab ntsa ntawm cov hlab ntsha (hyalinosis - kev tsim cov glycoproteins, uas, dhau los ntawm daim nyias nyias ntawm cov leeg ntawm capillaries, yooj yim poob tawm thiab muaj hyalinized).

Hyperglycemia Stimulates Cov Txheej Txheem protein glycosylation(glycosylation yog cov txheej txheem ntawm qhov tsis muaj enzymatic sib txuas ntawm cov piam thaj nrog cov amino pawg ntawm cov protein). Raws li qhov tshwm sim, cov khoom lag luam ruaj khov glycosylation yog tsim:

glycosylated hemoglobin. Muaj kev sib raug zoo rau cov pa oxygen, tsis muab nws rau cov ntaub so ntswg, hypoxia nthuav dav,

glycosylated apoproteins ntawm LDL thiab HDL, uas ua rau muaj qhov nce ntawm qhov feem ntawm LDL / HDL.

glycosylation ntawm cov protein ntawm coagulation thiab anticoagulation system, uas ua rau kom muaj zog ntawm cov ntshav tawm,

glycosylation ntawm cov protein pib ntawm lub qab daus membrane thiab collagen,

glycosylation ntawm myelin, uas ua rau muaj kev hloov pauv hauv nws cov qauv ntawm idemyelination,

glycosylation ntawm lub lens cov protein, uas ua rau kev txhim kho ntawm cataracts,

glycosylation ntawm insulin transporter proteins, uas ua rau cov insulin tsis kam, thiab lwm yam.

Txhua cov khoom glycosylation muaj cov qauv hloov pauv, uas txhais tau hais tias lawv tuaj yeem tau cov tshuaj tiv thaiv antigenic, vim qhov kev tiv thaiv autoimmune rau cov kabmob thiab cov nqaij ua haujlwm tau tsim.

Cov tshuaj insulin kuj tseem ua rau kev txhim kho lactic acidosis. Tus mechanisms:

Insulin deficiency ua rau inhibition of pyruvate dehydrogenase, vim qhov uas PVA tsis tig mus rau hauv AcCoA (kom hlawv hauv c. Krebs). Hauv qhov xwm txheej no, ntau dhau ntawm PVC hloov mus rau hauv lactate,

insulin deficiency ua kom muaj protein ntau catabolism, uas ua rau kev tsim cov roj ntsha muaj ntau ntxiv rau cov pyruvate thiab lactate,

cov ntaub so ntswg hypoxia, nrog rau kev nce ntxiv hauv cov kev ua ntawm cov tshuaj tiv thaiv contrainsular (tshwj xeeb tshaj yog adrenaline thiab STH) ua rau kev ua haujlwm ntawm anaerobic glycolysis, uas txhais tau tias nce ntxiv hauv kev tsim cov lactate.

Rog metabolism hauvnrog hom 1 mob ntshav qab zib mellitus, lawv tau cuam tshuam nrog kev tsis muaj qhov tsis txaus ntawm insulin thiab ib qho kev nce hauv kev ua ntawm cov tshuaj tiv thaiv contrainsular. Qhov no ua rau muaj kev txo qis hauv kev siv ntawm cov piam thaj los ntawm adipose ntaub so ntswg thaum txo lipogenesis thiab txhim kho lipolysis. (cov neeg mob uas muaj ntshav qab zib hom 1 yuag).

Raws li qhov tshwm sim, ketogenic amino acids (leucine, isoleucine, valine) thiab FFA nkag rau hauv lub siab, qhov uas lawv dhau los ua ib qho chaw cia rau ntau cov synthesis ntawm ketone lub cev (acetoacetic, b-hydroxybutyric, acetone). Yog tsimhyperketonemia.

Cov tshuaj lom ntau ntawm ketone lub cev:

inhibit lub zog ntawm cov tshuaj insulin thiab ua tsis tiav rau nws,

yaj ua membrane cov txheej txheem lipids, uas txhim kho cell puas,

inhibit qhov kev ua si ntawm ntau yam enzymes,

inhibit lub luag haujlwm ntawm lub hauv nruab nrab hauv lub paj hlwb,

ua rau kev txhim kho ntawm ketoacidosis,

ua rau kev tsim kho ntawm kev tiv thaiv kev tiv thaiv,

ua txhaum hemodynamics: inhibit myocardial kev cog lus thiab txo ntshav siab vim yog nthuav tawm ntawm cov hlab ntsha peripheral.

Protein metabolism hauv kev puas tsuajmob ntshav qab zib yog yus muaj los ntawm:

inhibition ntawm cov protein synthesis (insulin activates enzymes) thiab

kev nce hauv nws cov leeg hauv plab (insulin inhibits gluconeogenesis enzymes, nrog tsis muaj cov tshuaj insulin, AK mus rau kev tsim cov piam thaj),

ntxiv rau, AK conduction los ntawm cov kab mob cell yog cuam tshuam.

Raws li qhov tshwm sim, cov protein tsis txaus yog tsim nyob rau hauv lub cev, uas ua rau:

stunted kev loj hlob ntawm menyuam yaus

kom tsis txaus ntseeg cov txheej txheem yas,

qhov txhab kho kom zoo

txo cov khoom lag luam Ati

txo tsis kam mus rau kis kab mob,

ntxiv rau, kev hloov pauv hauv cov khoom ua haujlwm antigenic ntawm lub cev cov protein tuaj yeem ua rau lub cev ua haujlwm autoimmune.

Lwm yam mob ntshav qab zibmuab faib ua mob thiab mob ntev. Mob hnyav ua ntshav qab zib - coma. Cov Mob Hlwb - angiopathies thiab neuropathies.

Dienic angiopathies tau muab faib ua micro- thiab macroangiopathies.

Ntshav qab zib Microangiopathies - kev hloov pauv pathological hauv cov hlab ntawm microvasculature.

txuam nrog ntawm sorbitol thiab fructose nyob rau hauv cov hlab ntsa,

glycosylation khoom ntawm proteins ntawm lub qab daus membrane,

hyalinosis ntawm cov hlab phab ntsa,

Raws li qhov tshwm sim, cov qauv, cov metabolism thiab ua haujlwm ntawm lub nkoj phab ntsa tau ua txhaum, daim ntaub ischemia tsim. Cov ntaub ntawv tseem ceeb ntawm microangiopathies: retinopathy thiab nephropathy.

Tus mob ntshav qab zib ua pauj- microangiopathy ntawm cov hlab ntsha hlwb, hauv cov davhlau ya nyob twg theem ua rau tiav kev tsis pom kev. Microaneurysms, maculopathy, vitreous hemorrhages. Lwm yam mob - retinal detachment, Secondary glaucoma.

Ntshav Qab Zib Nepropathy- kev puas tsuaj tshwj xeeb rau microvasculature ntawm cov hlab ntsha ntawm lub raum, nrog rau kev tsim ntawm nodular los yog diffuse glomerulosclerosis thiab CRF hauv cov theem kawg.

Ntshav qab zib macroangiopathy- kev puas tsuaj rau cov hlab ntsha ntawm nruab nrab caliber.Tus mechanisms:

glycosylation ntawm cov kab mob hauv qab daus membrane,

txuam nrog ntawm sorbitol thiab fructose nyob rau hauv cov hlab ntsa,

Tag nrho cov no ua rau cov plaub tuab, qis ntawm cov hlab ntsha phab ntsa, nce permeability, ploj ntawm heparin receptors, platelet muaj ntau ntxiv, thiab kev ua kom zoo ntawm cov leeg ntawm tes ua kom loj hlob, uas txhais tau tias rau thaum ntxov thiab kho kom zoo duakev txhim khoatherosclerosisCov. Cov qauv tseem ceeb ntawm cov ntshav qab zib macroangiopathies:

kev puas tsuaj rau txoj hlab ntshav, yog li ntawd, mob plawv thiab mob plawv tsis zoo li nws cov kev mob tshwm sim,

kev puas tsuaj rau lub hlwb ntawm cov hlab ntsha hauv daim ntawv ntawm tus cwj nrag, hloov mus rau mob tsis zoo ntawm cov hlab hlwb thiab dementia,

occlusive lesions ntawm cov hlab ntsha ntawm qhov qis qis hauv daim ntawv ntawm kev sib quas ntus claudication, necrosis, mob caj dab.

Mob neuropathy mob ntshav qab zib- kev puas tsuaj rau cov hlab ntsha hauv ntshav qab zib.

peripheral hlab ntsha protein glycosylation,

kev tsim cov tshuaj tiv thaiv kom hloov cov tshuaj tiv thaiv kab mob thiab autoaggression in relation to antigens ntawm cov leeg hlwb,

tsub zuj zuj ntawm sorbitol thiab fructose hauv neurons thiab Schwann hlwb,

tsis muaj TSIS synthesis hauv phab ntsa txog ntsha.

Tag nrho cov no ua rau muaj kev cuam tshuam ntawm cov ntshav sib txuam, txo qis hauv cov hluavtaws ntawm myelin, thiab ua rau qeeb ntawm kev coj ua ntawm cov hlab ntaws impulses. Cov ntaub ntawv ntawm cov ntshav qab zib mob neuropathy:

CNS kev puas tsuaj (encephalopathy, myelopathy),

peripheral hlab ntsha puas tsuaj (polyneuropathy, mononeuropathy): lub cev muaj zog thiab hnov ​​tsis meej,

kev puas tsuaj rau lub hlwb autonomic leeg (autonomic neuropathy): kev cuam tshuam ntawm cov kev cai ntawm kev ua haujlwm ntawm lub plawv, lub suab voos, zais zis, lub plab zom mov.

Angiopathies thiab neuropathies tuaj yeem ua rau muaj ntshav qab zib mob hnyav xws li mob ntshav qab zib ko taw.

Mob ko taw- Lub pathological mob ntawm ko taw nyob rau hauv cov ntshav qab zib, yam ntxwv ntawm kev puas tsuaj rau ntawm daim tawv nqaij thiab cov nqaij mos, pob txha thiab pob qij txha thiab ua rau pom kev ua mob rau hauv lub cev, mob pob txha-pob txha thiab kev hloov ua pob txha thiab ua rau lub siab tawv (ua kom mob caj dab).

Mob hnyav ua ntshav qab zib - coma.

Mob qab zib comaCov. Qhov ncaj qha ua rau kev txhim kho mob ntshav qab zib tsis xeev (DC) nyob rau hauv cov ntshav qab zib tsis yog ntshav qab zib hauv nws tus kheej, vim nws cov chav kawm tsis tas yuav muaj kev nyuaj los ntawm kev txhim kho tsis nco qab,decompensation.

Decompensated mob ntshav qab zib- ib qho kev mob uas cov teeb meem hauv lub cev thiab cov khoom hauv nruab nrog cev hauv cov kab mob mus txog ib theem tseem ceeb thiab raug nrog kev puas tsuaj ntawm cov mob hauv lub cev: hyperosmolarity thiab lub cev qhuav dej, dyselectrolythemia, ketoacidosis, lactic acidosis, mob hypoxia, thiab lwm yam qee qhov kev hloov pauv no muaj peev xwmkev cuam tshuam rau lub hlwb, uas txhais tau hais tias ua rau lub caj dab coma.

Nyob ntawm seb hom mob ntshav qab zib mellitus thiab cov yam ntxwv ntawm tus yam ntxwv ua kom mob, yog ketoacidosis, lossis hyperosmolarity, lossis lactic acidosis yuav muaj nyob hauv tus neeg mob tshwj xeeb. Hauv qhov no, nws muaj 3 txoj kev xaiv rau DC:

ketoacidotic hyperglycemic coma,

hyperosmolar hyperglycemic coma,

Cov 3 ntau yam ntawm DC muaj qhov zoo sib xws pathogenesis cuam tshuam nrog kev txiav ntshav qab zib, tab sis nrog qhov muaj qhov tshwj xeeb ntawm ib qho kev mob tshwj xeeb hauv txhua kis.

Ntshav Qab Zib Hom 1 (IDDM)

Lub cev tsis tsim cov tshuaj insulin. Qee tus neeg siv rau hom no raws li muaj ntshav qab zib insulin-tiv thaiv ntshav qab zib, hluas ntshav qab zib lossis pib mob ntshav qab zib. Ntshav Qab Zib Hom 1 feem ntau yog kev cog lus ua ntej hnub nyoog 40, feem ntau thaum xeeb menyuam lossis thaum tiav hluas. Ntshav Qab Zib Hom 1 tsis nquag pom dua hom ob. Kwv yees li 10% ntawm tag nrho cov mob ntshav qab zib yog hom 1. Cov neeg mob ntshav qab zib hom 1 yuav tsum txhaj tshuaj insulin mus tas lawv lub neej. Lawv yuav tsum xyuas kom cov ntshav qabzib nyob rau hauv ntshav los ntawm kev kuaj ntshav tas li thiab ua raws li cov zaub mov tshwj xeeb. Hmoov tsis zoo, kev mob ntshav qab zib hom 1 tseem kho tsis tau, yam tsis muaj insulin rau hauv tus kab mob no, ib qho kev ua tsis taus sai sai tshwm sim, thiab tom qab ntawd ua rau tus neeg tuag taus. Mob mus ntev ntev ntawm cov ntshav qab zib hom 1 (cov kab mob ntshav qab zib angiopathy) tuaj yeem yog: dig muag, mob plawv, lub raum tsis ua hauj lwm, hniav ploj, dementia, mob rau qhov ncauj trophic (mus txog rau ntawm tes taw).

Ntshav Qab Zib Hom 2 (NIDDM)

Lub cev tsis tsim tawm cov insulin txaus rau kev ua haujlwm zoo, lossis lub hlwb hauv lub cev tsis teb rau insulin (insulin tsis kam). Kwv yees li 90% ntawm tag nrho cov mob ntshav qab zib thoob ntiaj teb muaj hom ntshav qab zib hom 2.

Qee tus neeg muaj peev xwm tswj hwm lawv cov tsos mob ntawm tus mob ntshav qab zib hom 2, poob ceeb thawj, tswj kev noj zaub mov zoo, qoj ib ce thiab tswj hwm lawv cov ntshav qabzib. Txawm li cas los xij, hom 2 raws li txoj cai - ib tus kab mob zoo zuj zus - nws maj mam zuj zus ntxiv - thiab tus neeg mob yuav tsum noj tshuaj txo cov ntshav qab zib, lossis tseem muaj tshuaj insulin.

Thawj tus neeg rog thiab cov neeg muaj rog muaj qhov phom sij ntau dua ntawm kev tsim hom 2 piv nrog cov neeg muaj lub cev noj qab nyob zoo. Cov neeg uas muaj lub cev rog ntau, kuj paub tias yog rog rog nruab nrab, rog rog, lossis rog rog rog, tshwj xeeb yog qhov muaj kev pheej hmoo.

Txoj kev pheej hmoo ntawm kev tsim hom ntshav qab zib hom 2 tseem tseem loj dua peb hnub nyoog. Cov kws tshaj lij tsis paub meej yog vim li cas, tab sis lawv hais tias thaum peb muaj hnub nyoog, peb zoo li yuav ua kom yuag thiab lub cev tsawg dua. Cov neeg uas muaj cov txheeb ze nyob ze lossis muaj hom 2 yog cov muaj feem yuav kis tau tus mob.

Mob ntshav qab zib thaum cev xeeb tub (mob ntshav qab zib hauv tes taw)

Hom no cuam tshuam rau cov poj niam thaum cev xeeb tub. Qee tus pojniam muaj cov ntshav qabzib cov ntshav siab ntau, lawv lub cev tsis tuaj yeem tsim cov insulin txaus rau kev xa txhua yam piam thaj mus rau cov cell, uas ua rau cov ntshav qabzib nce siab. Kab mob ntshav qab zib kuaj ntshav thaum kuaj pom kev muaj menyuam.

Cov neeg mob ntshav qab zib feem ntau thaum cev xeeb tub tuaj yeem tswj hwm lawv cov kev muaj mob los ntawm kev tawm dag zog thiab kev noj haus. Tab sis tseem tshuav li 10% -20% ntawm lawv yuav tsum tau noj qee yam tshuaj los tswj ntshav qab zib. Mob ntshav qab zib tsis tau tiv thaiv thiab tswj tsis tau tus pojniam thaum cev xeeb tub tuaj yeem ua rau muaj kev pheej hmoo mob ntxiv thaum menyuam yug menyuam. Tus menyuam tuaj yeem yug tau los ntau dua.

Qhov Ntshav Qab Zib Ua Ntej

Nws yuav tsum raug sau tseg tias kev poob ceeb thawj (tsawg kawg yog 5 txog 10 feem pua ​​ntawm koj lub sijhawm pib yuag) tuaj yeem tiv thaiv lossis ncua sijhawm mob ntshav qab zib lossis txawm kho tus mob ntshav qab zib ua ntej. Saib: Probiotics Tawm tsam Kev pham

Feem coob ntawm cov neeg mob uas muaj yam type 2 pib muaj ntshav qab zib ua ntej. Feem ntau cov neeg muaj ntshav qab zib ua ntej tshaj plaws yeej tsis muaj tsos mob tshwm sim. Koj tus kws kho mob yuav kuaj koj cov ntshav seb koj cov piam thaj hauv ntshav siab dua li ib txwm. Hauv cov ntshav qab zib ua ntej, cov ntshav qabzib feem ntau dhau li ib txwm, tab sis tsis siab txaus rau kev kuaj mob ntshav qab zib. Cov keeb ntawm lub cev ua rau cov tshuaj insulin. Cov kev tshawb fawb tau qhia tias txawm nyob hauv kev npaj ua ntej rau ntshav qab zib, qee qhov kev puas tsuaj rau cov hlab plawv thiab lub plawv tau tshwm sim.

* Rau kev siv tswv yim ntawm cov cuab yeej ntawm kev ua cov kab mob probiotic hauv kev tsim cov tshuaj tshiab rau kev kho thiab tiv thaiv ntawm dyslipidemia thiab ntshav qab zib, saib cov lus piav qhia ntawm probiotic "Bifikardio":

KEV THEM NQI, INSULIN THIAB CARBOHYDRATES

LOSSIS 12 KAUJ RUAJ RAU TXOJ KEV RAU LUB CAIJ

Txij li kev rog dhau los yog ib qho kev txiav txim siab hauv kev txhim kho ntshav qab zib, nws yuav pab tau kom nkag siab txog qhov txheej txheem no tshwm sim hauv lub cev thiab qhov twg ua rau nws mob.

Kev pham algorithm tuaj yeem sawv cev raws li hauv qab no: 1. koj xav txog khoom noj khoom haus, 2. koj pib tso tshuaj insulin, 3. insulin muab lub cev rau lub cim kom khaws cov roj fatty acids thiab tsis hlawv lawv, tso tawm lub zog, 4. koj xav tias tshaib plab, 5. Cov ntshav qab zib nce, 6. cov khoom noj yooj yim carbohydrates nkag rau koj cov ntshav ua hom ntshav qabzib; 7. koj pib txhawm rau insulin ntau dua; 8. koj pib noj; 9 koj muab cov insulin ntau dua; 10. cov rog rog muab tso rau hauv cov rog ua triglycerides; tau txais txawm tias 12. koj tau txais rog

Lub cev rog lossi mus thiab mus los ntawm cov kab ntawm lub cev. Thiab peb tau rov qab los ntawm cov rog uas tseem nyob hauv lub cev. Cov roj yog khaws cia rau hauv lub ntsej muag rog nyob hauv daim ntawv ntawm triglycerides. Triglycerides yog tsim los ntawm peb cov roj ntsha txuas nrog ib glycerol molecule hauv ib lub roj ntsha. Lawv loj dhau los tawm los ntawm cov qog ua kom muaj roj, tsis zoo li cov roj ntsha, uas tawm tau yooj yim. I.e. cov triglycerides ntau ntxiv, cov loj cov hlwb ua, loj dua peb ua.

Carbohydrates muaj qhov yooj yim (ceev) thiab ntau. Cov roj lossis nrawm yooj yim yog cov sib txuas uas muaj ib lossis ob lub monosaccharide lwg me me, thiab lawv yog cov muaj kev phom sij tshaj plaws ua rau kev rog.

Cov carbohydrates yooj yim tau muab faib ua ob pawg:

• Monosaccharides (qabzib, fructose, galactose),
• Kev tsis ncaj ncees (sucrose, lactose, maltose)

Yooj yim carbohydrates tam sim ntawd nqus los ntawm kev txhaj ntshav qabzib mus rau hauv cov ntshav. Qhov no ua rau muaj kev cuam tshuam rau kev tsim cov tshuaj insulin.

Cov tshuaj insulin - Qhov no yog qhov kev tswj qhov pib ntawm kev siv metabolism. Nws nyob ntawm nws qib seb puas muaj roj ntsha yuav sib txuas ua ke lossis cais. Thaum cov tshuaj insulin nce siab, cov lipoprotein lipase enzyme - (LPL) ua haujlwm, uas yog lub luag haujlwm rau cov roj ntws mus rau hauv lub cell. I.e. cov insulin ntau dua peb ua, cov LPL nquag siv ntau yog nqus cov roj ntsha nrog cov rog.

Yog li, kev tsim cov isulin yog los ntawm carbohydrates. Tus nqi thiab qhov ua tau zoo ntawm cov carbohydrates noj yuav txiav txim seb muaj roj ntau npaum li cas.

Thiab txhais tau tias

carbohydrates nce insulin -

- Cov tshuaj insulin txhawb cov rog rog

Ntawm cov ncauj lus, saib ntxiv:

Noj qab nyob zoo!

LUS CEEBHAIS TXOG TEJ KEV PAB CUAM NEEG