Cov yam ntxwv ntawm cov tshuaj insulin > Kev khomob thiab kev tiv thaiv

Cov tshuaj Insulin yog qhov ua kom cov ntshav qab zib tsawg, nws muaj peev xwm tswj cov metabolism hauv kev ua kom muaj roj, ua kom cov piam thaj muaj peev xwm ntau ntxiv los ntawm cov ntaub so ntswg thiab txhawb nws txoj kev hloov pauv mus rau glycogen, thiab kuj pab txhawb kev nkag mus ntawm cov piam thaj rau cov nqaij mos.

Ntxiv rau cov nyhuv hypoglycemic (txo qis ntshav qab zib), insulin muaj ntau yam teebmeem: nws nce cov nqaij glycogen khw muag khoom noj, txhawb peptide synthesis, txo kev noj protein ntau, thiab lwm yam.

Kev tsim tawm rau cov kua dej yog tsim nrog kev tsim tawm lossis kev txwv (txwv) ntawm qee yam enzymes, glycogen synthetase, pyruvate dehydrogenase, hexokinase yog cov tshuaj tiv thaiv, lipase ua kom muaj roj fatty acids ntawm adipose nqaij, lipoprotein lipase, txo cov ntshav txhaws tom qab noj mov nplua nuj, raug tiv thaiv.

Qhov ntsuas ntawm biosynthesis thiab kev zais zais (tso pa tawm) ntawm cov kua dej yog nyob ntawm cov concentration ntawm cov piam thaj hauv cov ntshav. Nrog rau kev nce ntxiv hauv nws cov ntsiab lus, pancreatic secretion ntawm cov tshuaj insulin nce, ntawm qhov tsis tooj, qhov txo qis hauv cov concentration ntawm cov piam thaj hauv cov ntshav ua rau cov kua dej insulin tsis pub tawm.

Insulin yog qhov tseem ceeb tshaj plaws rau kev kho mob ntshav qab zib mellitus, vim nws txo qis hyperglycemia (kev nce ntxiv hauv cov ntshav qab zib) thiab glycosuria (muaj cov piam thaj hauv cov zis), rov ua rau lub qog ntawm glycogen hauv lub siab thiab cov leeg, txo qhov tsim muaj cov piam thaj, thiab txo cov ntshav qab zib tsawg (muaj cov rog hauv cov ntshav) txhim kho kev mob ntawm tus neeg mob.

Cov tshuaj insulin rau kev siv kho mob yog tau los ntawm kev mob siab ntawm nyuj thiab npua. Muaj txheej txheem ntawm kev ua kom muaj zog sib xyaw ntawm cov tshuaj insulin, tab sis nws nkag tsis tau. Tsis ntev los no tsim cov txheej txheem biotechnological rau kev tsim tib neeg cov kua dej. Cov insulin tau los ntawm kev tsim hluav taws xob tau ua tiav sib xyaw rau amino acid series ntawm tib neeg cov insulin.

Nyob rau hauv rooj plaub uas muaj tshuaj insulin los ntawm tus tsiaj ntawm lub cev, ntau yam tsis txaus (proinsulin, glucagon, tus kheej-statin, cov protein, polypeptides, thiab lwm yam) tuaj yeem nyob rau hauv qhov kev npaj vim muaj kev huv huv tsis txaus. Tsis zoo lim cov tshuaj tua kab mob insulin tuaj yeem ua rau muaj kev phiv tshuaj ntau.

Cov txheej txheem niaj hnub ua rau nws muaj peev xwm ua kom tau purified (monopic - chromatographically purified nrog tso tawm ntawm "lub ncov" ntawm cov kua dej), ua kom huv (monocomponent) thiab crystallized insulin npaj. Tam sim no, crystalline tib neeg cov tshuaj insulin yog nce siv. Ntawm insulin npaj ntawm tsiaj keeb kwm, kev nyiam yog muab rau cov tshuaj insulin uas tau los ntawm kab mob qog npua ntawm npua.

Insulin kev ua ub no raug txiav txim siab biologically (los ntawm kev muaj peev xwm txo cov ntshav qab zib hauv luav zoo) thiab los ntawm ib qho ntawm kev siv lub cev (electrophoresis ntawm ntawv lossis chromatography ntawm ntawv). Rau ib chav ua haujlwm (UNIT), lossis chav thoob ntiaj teb (IE), coj cov haujlwm ntawm 0.04082 mg ntawm cov kua roj insulin crystalline.

Cov txheej txheem thov:

Hauv kev kho mob ntshav qab zib, kev npaj tshuaj insulin ntawm ntau qhov kev txiav txim siab tau siv (saib hauv qab).

Kev siv tshuaj insulin luv luv kuj tseem siv hauv qee lwm cov txheej txheem pathological: ua rau lub xeev hypoglycemic (txo qis ntshav qab zib) hauv qee yam mob schizophrenia, raws li cov tshuaj anabolic (txhim kho protein synthesis) nrog rau kev tso pa tawm dav dav, tsis muaj zaub mov noj, furunculosis (ntau yam purulent mob ntawm daim tawv nqaij) , thyrotoxicosis (mob qog), nrog cov kab mob ntawm lub plab (atony / poob ntawm lub suab /, gastroptosis / prolapse ntawm lub plab /), mob siab ntev (mob rau daim siab ua mob), nyh ntaub ntawv ntawm daim siab mob npuas paug, raws li zoo raws li ib tug tivthaiv "polarizing" dlaws siv los kho mob coronary insufficiency (mismatch ntawm mob oxygen thov thiab nws tus me nyuam).

Kev xaiv cov tshuaj insulin rau kev kho mob ntshav qab zib yog nyob ntawm qhov mob hnyav thiab cov yam ntxwv ntawm cov chav kawm ntawm tus kab mob, qhov xwm txheej dav dav ntawm tus neeg mob, nrog rau kev ceev ntawm qhov pib thiab lub sijhawm ntawm cov nyhuv hypoglycemic ntawm cov tshuaj. Lub hom phiaj tseem ceeb ntawm insulin thiab kev tsim cov koob tshuaj yog zoo dua nqa tawm hauv tsev kho mob (tsev kho mob).

Cov tshuaj insulin luv luv yog cov kev daws teeb meem rau subcutaneous lossis intramuscular cov thawj coj. Yog tias tsim nyog, lawv kuj raug tswj hwm hauv lub cev khov kho. Lawv muaj qhov nrawm nrawm thiab luv luv cov suab thaj txo cov nyhuv. Feem ntau lawv muab tshuaj subcutaneously lossis intramuscularly 15-20 feeb ua ntej noj mov los ntawm ib qho mus rau ntau zaus thaum nruab hnub. Cov nyhuv tom qab txhaj tshuaj subcutaneous tshwm sim tom qab 15-20 feeb, nce mus txog qhov siab kawg tom qab 2 teev, tag nrho lub sijhawm ua haujlwm tsis ntau tshaj 6 teev. Lawv siv feem ntau hauv tsev kho mob los tsim cov koob tshuaj xav tau ntawm insulin rau tus neeg mob, nrog rau cov xwm txheej uas yuav tsum tau ua kom tiav sai cov kev hloov pauv hauv insulin kev ua haujlwm hauv lub cev - nrog rau cov ntshav qab zib tsis nco qab thiab precom (ua tiav lossis ib nrab ntawm qhov tsis nco qab vim tias maj mam nce siab hauv cov ntshav qab zib).

Ntxiv rau tog tog 9, kev npaj insulin luv luv yog siv los ua tus neeg sawv cev anabolic thiab raug xaj, raws li txoj cai, hauv kev txhaj tshuaj me me (4-8 units 1-2 zaug hauv ib hnub).

Kev siv tshuaj ntev (ntev ntev) insulin npaj muaj nyob rau hauv ntau cov ntawv sau nrog ntau qhov sib txawv ntawm cov suab thaj txo cov txiaj ntsig (semylong, ntev, ultralong). Rau cov tshuaj sib txawv, cov nyhuv kav ntev li 10 mus rau 36 teev. Ua tsaug rau cov tshuaj no, cov naj npawb ntawm kev txhaj tshuaj txhua hnub tuaj yeem txo. Lawv feem ntau yog tsim nyob rau hauv daim ntawv ntawm kev ncua (kev ncua ntawm cov khoom zoo ntawm cov tshuaj hauv kua), tswj tsuas yog subcutaneously lossis intramuscularly, kev tso ntshav tawm tsis pub. Hauv kev mob ntshav qab zib tsis nco qab thiab precomatous, ntev lub sij hawm cov tshuaj tsis siv.

Thaum xaiv cov tshuaj insulin, nws yog ib qho tsim nyog yuav tsum xyuas kom meej tias lub sijhawm ntawm cov txiaj ntsig qab zib kom qis tshaj plaws yuav ua rau lub sijhawm koj noj nws. Yog tias tsim nyog, 2 cov tshuaj ntawm qhov kev txiav txim siab ntev tuaj yeem muab rau hauv ib leeg. Qee tus neeg mob yuav tsum tsis ntev xwb, tab sis kuj tseem ceev ceev ntawm cov ntshav qabzib hauv cov ntshav. Lawv yuav tsum sau cov tshuaj insulin ntev thiab luv luv.

Feem ntau, cov tshuaj muaj yeeb-ntev tau siv ua ntej noj tshais, tab sis yog tias tsim nyog, kev txhaj tshuaj tuaj yeem ua tiav ntawm lwm teev.

Txhua qhov kev npaj rau insulin yog siv ua raws kev noj haus. Lub ntsiab lus ntawm lub zog nqi sau (los ntawm 1700 txog 3000 khal) yuav tsum txiav txim siab los ntawm tus neeg mob lub cev qhov hnyav thaum lub sijhawm kho, los ntawm hom haujlwm. Yog li, nrog kev noj zaub mov kom tsawg thiab ua kom lub cev muaj zog, tus naj npawb ntawm cov calories uas yuav tsum tau nyob rau ib hnub rau tus neeg mob yog tsawg kawg 3000, nrog kev noj zaub mov ntau dhau thiab kev ua neej nyob rau sedentary, nws yuav tsum tsis pub tshaj 2000.

Qhia txog kev noj tshuaj ntau dhau, nrog rau qhov tsis muaj carbohydrates nrog cov zaub mov, tuaj yeem ua rau lub xeev ntshav qab zib (txo cov ntshav qab zib), nrog rau kev xav ntawm kev tshaib plab, tsis muaj zog, tawm hws, lub cev tshee tshee, mob taub hau, kiv taub hau, mob caj dab, mob euphoria (causally zoo siab) lossis kev txhoj puab heev Cov. Tom qab, hypoglycemic coma yuav tshwm sim (tsis nco qab, tus yam ntxwv ua tiav ntawm qhov tsis txaus ntawm lub cev rau qhov kev xav sab nraud vim tias qhov txo qis hauv cov ntshav qab zib) nrog poob ntawm kev nco qab, qaug dab peg, thiab ib qho kev poob ntawm lub plawv dhia. Txhawm rau tiv thaiv lub xeev hypoglycemic, cov neeg mob yuav tsum haus dej qab zib lossis noj ob peb daim qab zib.

Nrog lub ntsej muag hypoglycemic (cuam tshuam nrog kev txo qis hauv cov ntshav qab zib), 40% kua nplaum tov rau hauv cov ntshav hauv qhov nyiaj ntawm 10-40 ml, qee zaum txog 100 ml, tab sis tsis muaj ntxiv.

Kev kho ntawm hypoglycemia (txo cov ntshav qab zib) hauv cov qauv mob tuaj yeem nqa tawm los ntawm kev siv tshuaj intramuscular lossis subcutaneous ntawm glucagon.

Cov xwm txheej tsis zoo:

Nrog kev tswj hwm ntawm subcutaneous ntawm insulin npaj, lipodystrophy (txo qis ntawm adipose nqaij hauv cov nqaij subcutaneous) yuav tshwm sim ntawm qhov chaw txhaj tshuaj.

Niaj hnub ua kom huv si insulin npaj tsis tshua muaj kev ua xua tshwm sim, txawm li cas los xij, cov rooj plaub zoo li no tsis raug cais. Kev txhim kho ntawm qhov muaj mob tsis haum yuav tsum tau ua kom sai (tiv thaiv lossis tiv thaiv kev fab tshuaj) kev hloov kho thiab hloov tshuaj.

Cov Tshuaj Tiv Thaiv:

Cov tshuaj tiv thaiv kom tsis txhob siv cov tshuaj insulin yog cov kab mob uas tshwm sim nrog hypoglycemia, mob siab, mob ntshav siab, mob qog ntshav siab (mob rau ntawm daim tawv nqaij thiab cov qog ua kua rau ntawm lub qhov muag los ntawm kev tawg ntawm cov ntshav liab), pancreatitis (mob rau lub raum), mob nephritis (mob rau lub raum) lub raum mob cuam tshuam nrog cov protein tsis txaus / amyloid metabolism), urolithiasis, mob plab thiab duodenal mob, decompensated lub plawv tsis zoo (lub plawv tsis ua haujlwm vim lub plawv tsis ua haujlwm kab mob ntawm nws li qub).

Kev ceeb toom loj yog qhov yuav tsum tau ua hauv kev kho mob rau cov neeg mob ntshav qab zib mellitus, kev txom nyem los ntawm kev tsis txaus siab rau lub plawv (kev tsis sib luag ntawm lub siab xav tau oxygen thiab nws txoj kev xa tawm) thiab lub hlwb tsis zoo | ntshav ncig. Ceev faj yog qhov tsim nyog thaum thov insulin! nyob rau hauv cov neeg mob uas muaj cov thyroid, Addison's disease (tsis muaj peev xwm ua tsis txaus adrenal), lub raum tsis ua haujlwm.

Kev siv tshuaj insulin rau cev xeeb tub yuav tsum> ua tib zoo saib xyuas. Nyob rau thawj peb lub hlis thaum cev xeeb tub, qhov xav tau rau insulin feem ntau poob qis me ntsis thiab nce ntxiv hauv qib thib ob thiab thib peb.

Alpha-adrenergic blockers thiab beta-adrenostimulants, tetracyclines, salicylates nce lub zais ntawm cov endogenous (kev ua haujlwm ntawm lub cev tsim) insulin. Thiazide diupetics (diuretics), beta-blockers, cawv tuaj yeem ua rau cov ntshav qab zib tsawg.

Cia rau cov neeg mob:

Khaws ntawm qhov kub ntawm +2 txog + 10 * C. Tsis pub kom khov cov tshuaj txwv.

Depo-N-insulin, Isofaninsulin, Iletin I, Insulinatard, Insulin B, Insulin-B SC, Insulin BP, Insulin M, Insulin Actrapid MS, Insulin Actrapid FM, Insulin Actrapid FM Penfill, Insulin Velosulin, Insulin Xev, Insulin Tape, Insulin Tape, Insulin Tape, Insulin Tape, Insulin Xev Insulin daim kab xev MK, Insulin monotard, Insulin monotard MK, Insulin monotard NM, Insulin protofan NM memfill, Insulin rapard MK, Insulin semilent MS, Insulin superlente, Insulin ultlente, Insulin ultlente MS, Insulin ultongardum, Insulinlingleng, Insulinlingleng, Insulinlingleng, Insulong, Insulrap GP , Insulrap R, Insulrap SPP, Insuman basal, Insuman comb, Insuman sai, Insuman sai, Insuman sai rau optipena, Comb-N-insulin Hoechst, Daim kab xev ilethin I, Daim kab xev ilethin II, Monosuinsulin, N-Insulin Hoechst, N-Insulin Hoehst 100 Iletin I, NPH Iletin II, Ntu Iletin I, Ib txwm Iletin II, Suinsulin, Homorap-100, Homofan 100, Humulin L, Humulin Mi, Humulin Mj, Humulin Mz, Humulin M4, Humulin N, Humulin NPH, Humulin R Humulin S, Humulin daim kab xev, Humulin tsis tu ncua, Humulin ultralente.

1 ml ntawm kev daws lossis ncua kev kawm feem ntau muaj 40 units.

Ua raws li cov peev txheej ntawm cov khoom tsim tawm, cov kua dej insulin yog cais tawm ntawm cov tsiaj ua kua thiab ua kom sib xyaw ua ke siv cov txheej txheem engineering tsim. Raws li cov neeg kawm ntawv ntawm kev ua kom huv, kev npaj tshuaj insulin los ntawm cov tsiaj cov nqaij tau muab faib ua monopic (MP) thiab monocomponent (MK). Tam sim no tau los ntawm npua npua, lawv muaj ntxiv nrog rau tsab ntawv C (SMP - nqaij npuas monopic, SMK - nqaij npuas monocomponent), nyuj - tsab ntawv G (nqaij nyug: GMP - nqaij nyuj monopick, GMK - nqaij nyug monocomponent). Kev tiv thaiv tib neeg ntawm insulin yog qhia los ntawm tsab ntawv C.

Ua raws li lub sijhawm ua ntawm kev ua, insulins tau muab faib ua:

a) luv luv insulin npaj: pib ntawm kev nqis tes ua tom qab 15-30 feeb, qhov kawg siab kawg tom qab 1 / 2-2 teev, tag nrho lub sijhawm ua ntawm 4-6 teev,

b) insulin ua yeeb yaj kiab npaj ntev ntev muaj xws li tshuaj ntawm nruab nrab lub sijhawm (pib tom qab 1 / 2-2 teev, ncov tom qab 3-12 teev, tag nrho lub sijhawm 8-12 teev), siv yeeb tshuaj ntev (pib tom qab 4-8 teev, ncov tom qab 8-18 teev, tag nrho lub sijhawm ntawm 20-30 teev).

Npaj cov ua zoo sib xws:

Yog tias koj muaj kev paub txog tshuaj no rau koj cov neeg mob - qhia qhov tshwm sim (tawm ib saib)! Cov tshuaj no puas pab tau tus neeg mob, puas tau muaj tshwm sim thaum lub sijhawm kho? Koj cov kev paub yuav txaus siab rau ob qho tib si koj cov npoj yaig thiab cov neeg mob.

Yog tias cov tshuaj no tau raug kho rau koj thiab koj tau mus ntsib ib txoj kev kho, qhia kuv yog tias nws ua haujlwm zoo (txawm nws pab tau), seb puas muaj kev phiv, koj nyiam / tsis nyiam li cas. Ntau txhiab leej neeg tab tom nrhiav tshuaj xyuas online ntawm ntau yam tshuaj. Tab sis tsuas yog qee leej tawm lawv. Yog tias koj tus kheej tsis tawm cov lus taw qhia ntawm cov ncauj lus no - tas yuav tsis muaj dab tsi nyeem.

Lub Npe: Cov tshuaj insulin

Kev taw qhia rau kev siv:
Qhov tseem ceeb qhia txog kev siv tshuaj insulin yog hom I ntshav qab zib mellitus (insulin-dependant), tab sis nyob rau qee qhov xwm txheej nws kuj tau sau tseg rau hom II mob ntshav qab zib mellitus (non-insulin-dependant).

Pharmacological kev txiav txim:
Cov tshuaj Insulin yog qhov ua kom cov ntshav qab zib tsawg, nws muaj peev xwm tswj cov metabolism hauv kev ua kom muaj roj, ua kom cov piam thaj muaj peev xwm ntau ntxiv los ntawm cov ntaub so ntswg thiab txhawb nws txoj kev hloov pauv mus rau glycogen, thiab kuj pab txhawb kev nkag mus ntawm cov piam thaj rau cov nqaij mos.
Ntxiv rau cov nyhuv hypoglycemic (txo qis ntshav qab zib), insulin muaj ntau yam teebmeem: nws nce cov nqaij glycogen khw muag khoom noj, txhawb peptide synthesis, txo kev noj protein ntau, thiab lwm yam.
Kev tsim cov tshuaj insulin yog nrog kev tsim tawm lossis kev txwv (txwv) ntawm qee yam enzymes, glycogen synthetase, pyruvate dehydrogenase, hexokinase raug tsim kho, lipase ua kom muaj roj fatty acids ntawm adipose nqaij, lipoprotein lipase, uas txo cov "haze" ntawm ntshav ntshav tom qab noj mov nplua nuj, muaj kev cuam tshuam.
Qhov ntsuas ntawm biosynthesis thiab kev zais zais (tso pa tawm) ntawm cov kua dej yog nyob ntawm cov concentration ntawm cov piam thaj hauv cov ntshav. Nrog rau kev nce ntxiv hauv nws cov ntsiab lus, pancreatic secretion ntawm cov tshuaj insulin nce, ntawm qhov tsis tooj, qhov txo qis hauv cov concentration ntawm cov piam thaj hauv cov ntshav ua rau cov kua dej insulin tsis pub tawm.
Hauv kev siv ntawm kev cuam tshuam los ntawm cov tshuaj insulin, lub luag haujlwm tseem ceeb yog ua si los ntawm nws kev sib cuam tshuam nrog ib qho tshwj xeeb receptor hauv zos ntawm lub plasma daim nyias nyias ntawm tes, thiab tsim muaj cov insulin receptor complex. Cov tshuaj insulin hauv kev sib xyaw nrog cov tshuaj insulin nkag mus rau hauv lub cell, qhov twg nws cuam tshuam phospholation ntawm cov xovtooj ntawm cev, cov kev tawm suab hauv lub hlwb tsis tau to taub tag nrho.
Insulin yog qhov tseem ceeb tshaj plaws rau kev kho mob ntshav qab zib mellitus, vim nws txo qis hyperglycemia (kev nce ntshav hauv cov ntshav qabzib) thiab glycosuria (muaj ntshav qab zib hauv cov zis), rov ua rau cov qog glycogen hauv lub siab thiab cov leeg, txo cov ntshav qabzib ntau, thiab alleviates lipemia (muaj cov rog hauv cov ntshav) , txhim kho kev mob ntawm tus neeg mob.
Cov tshuaj insulin rau kev siv kho mob yog tau los ntawm kev mob siab ntawm nyuj thiab npua. Muaj txheej txheem ntawm kev ua kom muaj zog sib xyaw ntawm cov tshuaj insulin, tab sis nws nkag tsis tau. Xyoo tsis ntev los no, cov txheej txheem biotechnological rau kev tsim cov tshuaj insulin tib neeg tau raug tsim tawm. Cov insulin tau los ntawm kev tsim hluav taws xob yog tsim los ntawm amino amino series ntawm tib neeg cov insulin.
Nyob rau hauv rooj plaub uas insulin tau txais los ntawm tus tsiaj ntawm lub cev, muaj ntau yam impurities (proinsulin, glucagon, tus kheej-statin, cov protein, polypeptides, thiab lwm yam) tuaj yeem muaj nyob rau hauv cov khoom vim tsis txaus huv. Cov tshuaj tua kab mob insulin tsis zoo tuaj yeem ua rau muaj kev phiv tshuaj ntau.
Cov txheej txheem niaj hnub ua rau nws muaj peev xwm ua kom tau purified (monopic - chromatographically purified nrog tso tawm ntawm "ncov" ntawm cov kua dej), ua kom huv (monocomponent) thiab crystallized insulin khoom. Tam sim no, crystalline tib neeg cov tshuaj insulin yog nce siv. Ntawm cov khoom lag luam ntawm insulin ntawm tsiaj keeb kwm, kev nyiam yog muab rau cov tshuaj insulin uas tau los ntawm kab mob qaj ntawm npua.
Insulin kev ua ub no raug txiav txim siab biologically (los ntawm kev muaj peev xwm txo cov ntshav qab zib hauv luav zoo) thiab los ntawm ib qho ntawm kev siv lub cev (electrophoresis ntawm ntawv lossis chromatography ntawm ntawv). Rau ib chav ua haujlwm (UNIT), lossis chav thoob ntiaj teb (IE), coj cov haujlwm ntawm 0.04082 mg ntawm cov kua roj insulin crystalline.

Muab cov tshuaj insulin thiab Cov Thawj Coj:
Hauv kev kho mob ntshav qab zib, cov tshuaj insulin ntawm cov kev ua haujlwm sib txawv yog siv (saib hauv qab).
Kev siv tshuaj insulin luv luv kuj tseem siv nyob rau hauv ntau lwm txoj kev hauv lub hauv paus: ua rau lub xeev ntshav qab zib (txo qis ntshav qab zib) nyob rau qee yam mob schizophrenia, ua ib qho anabolic (txhim kho protein synthesis) tshuaj nrog kev tso pa tawm dav dav, malnutrition, furunculosis (ntau daim tawv nqaij purulent) ), thyrotoxicosis (mob qog), nrog cov kab mob ntawm lub plab (atony / poob ntawm lub suab /, gastroptosis / prolapse ntawm lub plab /), mob siab ntev (mob rau daim siab ua mob), lax cov qauv mob siab rau lub siab, nrog rau kev tiv thaiv "polarizing" cov tshuaj siv los kho lub plawv tsis txaus (tsis ncaj nruab nrab ntawm qhov xav tau oxygen ntawm lub plawv thiab qhov nws xa tawm).
Kev xaiv cov tshuaj insulin rau kev kho mob ntshav qab zib yog nyob ntawm qhov mob hnyav thiab cov yam ntxwv ntawm cov chav kawm ntawm tus kabmob, qhov xwm txheej ntawm tus neeg mob, nrog rau qhov ceev ntawm qhov pib thiab lub sijhawm ntawm cov suab thaj-txo cov nyhuv ntawm cov khoom. Lub hom phiaj tseem ceeb ntawm insulin thiab kev tsim cov koob tshuaj yog zoo dua nqa tawm hauv tsev kho mob (tsev kho mob).
Cov tshuaj insulin luv luv yog cov kev daws teeb meem rau subcutaneous lossis intramuscular cov thawj coj. Yog tias tsim nyog, lawv kuj raug tswj hwm hauv lub cev khov kho. Lawv muaj qhov nrawm nrawm thiab luv luv cov suab thaj txo cov nyhuv. Feem ntau lawv siv cov subcutaneously lossis intramuscularly 15-20 feeb ua ntej noj mov los ntawm ib mus rau ntau zaus thoob plaws hauv lub hnub. Cov nyhuv tom qab txhaj tshuaj subcutaneous tshwm sim tom qab 15-20 feeb, nce mus txog qhov siab kawg tom qab 2 teev, tag nrho cov kev ua ntawm lub sijhawm tsis yog ntau tshaj 6 teev. Lawv siv feem ntau hauv tsev kho mob los tsim cov koob tshuaj uas xav tau ntawm cov tshuaj insulin rau tus neeg mob, kuj muaj nyob rau hauv cov xwm txheej ntawd thaum nws tsim nyog kom ua tiav sai cov kev hloov pauv hauv insulin kev ua haujlwm hauv lub cev - nrog rau cov ntshav qab zib tsis nco qab thiab precom (ua tiav lossis ib nrab ntawm qhov tsis nco qab vim tias maj mam nce siab hauv cov ntshav qab zib).
Ntxiv nrog rau tog 9, cov tshuaj insulin luv luv tau siv los ua tus neeg sawv cev anabolic thiab raug xaj, raws li txoj cai, hauv kev txhaj tshuaj me me (4-8 units 1-2 zaug hauv ib hnub).
Kev siv tshuaj ntev (ntev ntev) insulin npaj muaj nyob rau hauv ntau cov ntawv sau nrog ntau qhov sib txawv ntawm cov suab thaj txo cov txiaj ntsig (semylong, ntev, ultralong). Rau cov khoom lag luam sib txawv, cov nyhuv ntev li 10 mus rau 36 teev. Ua tsaug rau cov khoom lag luam no, cov naj npawb ntawm kev txhaj tshuaj txhua hnub tuaj yeem txo. Lawv feem ntau yog tsim nyob rau hauv daim ntawv ntawm kev ncua (kev ncua ntawm qhov khoom me me ntawm cov khoom hauv kua), tswj tsuas yog subcutaneously lossis intramuscularly, kev tso ntshav tawm tsis pub. Hauv kev mob ntshav qab zib tsis nco qab thiab precomatous, cov khoom lag luam ntev tsis siv.
Thaum xaiv cov tshuaj insulin, nws yog ib qho tsim nyog yuav tsum ua kom paub meej tias lub sijhawm ntawm cov siab kawg ntawm cov piam thaj txo qis yuav luag nrog lub sijhawm koj sau. Yog tias tsim nyog, 2 cov khoom lag luam ntawm lub caij nyoog ntev tuaj yeem ua haujlwm hauv ib lub koob txhaj. Qee tus neeg mob yuav tsum tsis ntev xwb, tab sis kuj tseem ceev ceev ntawm cov ntshav qabzib hauv cov ntshav. Lawv yuav tsum sau cov tshuaj insulin ntev thiab luv luv.
Feem ntau, cov khoom tso tawm ntev ntev tau muab rau noj ua ntej noj tshais, tab sis yog tias tsim nyog, kev tuaj yeem hno tau lwm lub sijhawm.
Tag nrho cov tshuaj insulin yog siv yog tias ua kom tau raws li kev noj haus tau ua. Lub ntsiab lus ntawm lub zog nqi sau (ntawm 1700 txog 3000 khal) yuav tsum txiav txim siab lub cev qhov hnyav ntawm tus neeg mob thaum lub sijhawm kho, los ntawm hom kev ua si. Yog li, nrog kev noj zaub mov kom tsawg thiab lub zog ua haujlwm hnyav, tus naj npawb ntawm cov calories uas yuav tsum tau nyob rau ib hnub rau tus neeg mob yog tsawg kawg 3000, nrog kev noj zaub mov ntau dhau thiab kev ua neej nyob rau sedentary, nws yuav tsum tsis pub tshaj 2000.
Kev qhia ntawm kev noj tshuaj ntau dhau lawm, nrog rau qhov tsis muaj carbohydrates nrog zaub mov, tuaj yeem ua rau lub xeev ntshav tsis zoo (txo qis ntshav qab zib), nrog rau kev xav ntawm kev tshaib plab, tsis muaj zog, tawm hws, tshee tshee ntawm lub cev, mob taub hau, kiv taub hau, palpitations, euphoria (causally zoo siab) lossis kev txhoj puab heev. Hauv kev ua rau lub cev tsis ua rau lub cev tsis ua hauj lwm zoo (tsis nco qab, ua rau lub cev tsis muaj qhov kev cuam tshuam ntawm sab nraud vim yog qhov ua kom cov ntshav qab zib tsawg) nrog kev poob ntawm kev nco qab, ua kom mob thiab ua rau lub plawv dhia tsis zoo. Txhawm rau tiv thaiv lub xeev hypoglycemic, cov neeg mob yuav tsum haus dej qab zib lossis noj ob peb daim qab zib.
Nrog lub ntsej muag hypoglycemic (cuam tshuam nrog kev txo qis hauv cov ntshav qab zib), 40% kua nplaum tov rau hauv cov ntshav hauv qhov nyiaj ntawm 10-40 ml, qee zaum txog 100 ml, tab sis tsis muaj ntxiv.
Kev kho ntawm hypoglycemia (txo cov ntshav qab zib) hauv cov qauv mob tuaj yeem nqa tawm los ntawm kev siv tshuaj intramuscular lossis subcutaneous ntawm glucagon.

Cov tshuaj insulin contraindications:
Cov tshuaj tiv thaiv rau kev siv tshuaj insulin yog cov kab mob uas tshwm sim nrog hypoglycemia, kab mob siab, mob ntsws, mob hemolytic jaundice (mob rau ntawm daim tawv nqaij thiab cov qog ua kua rau ntawm lub qhov muag los ntawm kev tawg ntawm cov ntshav liab), pancreatitis (mob rau lub raum), mob nephritis (mob rau lub raum) lub raum mob cuam tshuam nrog cov protein tsis txaus / amyloid metabolism), urolithiasis, mob plab thiab duodenal mob, decompensated lub plawv tsis zoo (lub plawv tsis ua haujlwm vim yog nris) levania ntawm nws li qub).
Kev ceeb toom loj yog qhov yuav tsum tau ua hauv kev kho mob ntawm cov neeg mob ntshav qab zib mellitus, kev txom nyem los ntawm kev txhim kho cov hlab ntsha tsis txaus (ib qho tsis sib xws ntawm qhov xav tau oxygen nyob rau hauv lub siab thiab qhov xa) thiab lub hlwb tsis zoo | ntshav ncig. Ceev faj yog qhov tsim nyog thaum siv tshuaj insulin! hauv cov neeg mob uas muaj cov thyroid, Addison's disease (tsis muaj peev xwm ua tsis txaus adrenal), lub raum tsis ua haujlwm.
Kev siv tshuaj kho cov tshuaj insulin rau cev xeeb tub yuav tsum ua> hauv kev saib xyuas zoo. Nyob rau thawj peb lub hlis thaum cev xeeb tub, qhov xav tau rau insulin feem ntau poob qis me ntsis thiab nce ntxiv hauv qib thib ob thiab thib peb.
Alpha-adrenergic blockers thiab beta-adrenostimulants, tetracyclines, salicylates nce lub zais ntawm cov endogenous (kev ua haujlwm ntawm lub cev tsim) insulin. Thiazide diupetics (diuretics), beta-blockers, cawv tuaj yeem ua rau cov ntshav qab zib tsawg.

Cov tshuaj insulin:
Nrog kev tswj hwm ntawm subulinaneous ntawm cov tshuaj insulin, lipodystrophy (kev txo qis hauv cov ntim ntawm adipose nqaij hauv cov nqaij subcutaneous) yuav tshwm sim ntawm qhov chaw txhaj tshuaj.
Niaj hnub nimno siab-cov ntshiab insulin khoom kuj tsis tshua muaj kev ua xua tshwm sim, txawm li cas los xij, cov rooj plaub zoo li no tsis raug cais. Txoj kev txhim kho ntawm cov tshuaj tiv thaiv tsis haum yuav tsum tau ua kom sai (tiv thaiv los yog tiv thaiv kev tsis haum tshuaj) kev kho thiab hloov khoom.

Daim ntawv tso tawm:
Syringe insulin muaj nyob hauv iav fwj hermetically kaw nrog roj hmab stoppers nrog txhuas tawg-hauv.

Txhais:
Depo-N-insulin, Isofaninsulin, Iletin I, Insulinatard, Insulin B, Insulin-B SC, Insulin BP, Insulin M, Insulin Actrapid MS, Insulin Actrapid FM, Insulin Actrapid FM Penfill, Insulin Velosulin, Insulin Xev, Insulin Tape, Insulin Tape, Insulin Tape, Insulin Tape, Insulin Xev Insulin daim kab xev MK, Insulin monotard, Insulin monotard MK, Insulin monotard NM, Insulin protofan NM memfill, Insulin rapard MK, Insulin semilent MS, Insulin superlente, Insulin ultlente, Insulin ultlente MS, Insulin ultongardum, Insulinlingleng, Insulinlingleng, Insulinlingleng, Insulong, Insulrap GP , Insulrap R, Insulrap SPP, Insuman basal, Insuman comb, Insuman sai, Insuman sai, Insuman sai rau optipena, Comb-N-insulin Hoechst, Daim kab xev ilethin I, Daim kab xev ilethin II, Monosuinsulin, N-Insulin Hoechst, N-Insulin Hoehst 100 Iletin I, NPH Iletin II, Ntu Iletin I, Ib txwm Iletin II, Suinsulin, Homorap-100, Homofan 100, Humulin L, Humulin Mi, Humulin Mj, Humulin Mz, Humulin M4, Humulin N, Humulin NPH, Humulin R Humulin S, Humulin daim kab xev, Humulin tsis tu ncua, Humulin ultralente.

Cia rau cov neeg mob:
Khaws ntawm qhov kub ntawm +2 txog + 10 * C. Tsis pub khov cov khoom lag luam.

Cov tshuaj insulin:
1 ml ntawm kev daws lossis ncua kev kawm feem ntau muaj 40 units.
Ua raws li cov peev txheej ntawm cov khoom tsim tawm, cov kua dej insulin yog cais tawm ntawm cov tsiaj ua kua thiab ua kom sib xyaw ua ke siv cov txheej txheem engineering tsim. Raws li cov neeg kawm ntawv ntawm kev ua kom huv, kev npaj tshuaj insulin los ntawm cov tsiaj cov nqaij tau muab faib ua monopic (MP) thiab monocomponent (MK). Tam sim no tau los ntawm npua npua, lawv muaj ntxiv nrog rau tsab ntawv C (SMP - nqaij npuas monopic, SMK - nqaij npuas monocomponent), nyuj - tsab ntawv G (nqaij nyug: GMP - nqaij nyuj monopick, GMK - nqaij nyug monocomponent). Kev tiv thaiv tib neeg ntawm insulin yog qhia los ntawm tsab ntawv C.
Ua raws li lub sijhawm ua ntawm kev ua, insulins tau muab faib ua:
a) cov yeeb yam luv luv insulin cov khoom: qhov pib ntawm kev ua tom qab 15-30 feeb, qhov kawg siab kawg tom qab 1 / 2-2 teev, tag nrho lub sijhawm ntawm kev ua 4-6 teev,
b) insulin cov khoom lag luam ntev xws li cov khoom nruab nrab (pib tom qab 1 / 2-2 teev, ncov tom qab 3-12 teev, tag nrho lub sijhawm 8-12 teev), cov khoom lag luam ntev (pib tom qab 4-8 teev, ncov tom qab 8-18 teev, tag nrho lub sijhawm ntawm 20-30 teev).

Saib xyuas!
Ua ntej siv cov tshuaj, koj yuav tsum sab laj nrog koj tus kws kho mob.
Cov lus qhia yog muab tsuas yog kom nkag siab txog koj tus kheej "".

Lub luag haujlwm tseem ceeb ntawm cov tshuaj hormone insulin tsis yog tsuas yog ua kom qis dua qhov muaj ntshav qabzib dhau mus rau ib qib, tab sis kuj tseem yuav xa nws, nrog rau lwm cov as-ham uas tus neeg tau txais nrog cov zaub mov, rau txhua lub cev ntawm lub cev. Cov insulin receptor nyob rau thaj chaw ntawm txhua lub cell thiab lawv lub luag haujlwm yog kom pauv cov as-ham thiab cov tshuaj insulin hauv sab hauv pab lub hlwb nqus cov tshuaj.

Yog tias tus txiav txim siab, qhov twg los ntawm cov tshuaj hormones, tsis tuaj yeem ua lub luag haujlwm thiab tsis tsim nws cov khoom, tus neeg tsis tau txais lub zog los ntawm cov khoom noj. Txawm hais tias theem ntawm cov piam thaj hauv cov ntshav tau nce siab, nws tsis yog siv rau nws lub hom phiaj uas tau npaj tseg, thiab cov cell mus rau qhov tsis tau txais yuav pib muaj kev tshaib plab thiab tuag tom qab ib pliag.

Ua ntej, qhov no coj mus rau malfunctions hauv lub cev, ces tuag. Ib me ntsis ntau tshaj ib puas xyoo dhau los, tus neeg mob kuaj mob ntshav qab zib tau ploj mus. Tab sis tom qab nrhiav tau cov tshuaj insulin, cov neeg mob ntshav qab zib tau muaj txoj hau kev los ua lub neej noj qab haus huv, tshwj xeeb tshaj yog vim cov tshuaj insulin npaj txhij rau kev muag: lawv tus nqi yog qhov pheej yig thiab tuaj yeem yuav tom txhua lub tsev muag tshuaj.

Cov tshuaj ntawm pab pawg pharmacological tsis tau hais tawm cov tshuaj insulin tam sim: lawv ua nws tom qab cov ntsiav tshuaj uas txo cov ntshav qabzib tsis muaj txiaj ntsig. Daim qauv tshuaj yog xim tsis muaj kob lossis daj kua ntshiab. Cov khoom tsim los rau kev txhaj tshuaj hauv tsev yog tsim hauv hwj, daim ntawv tso tawm yog tsib thiab kaum millilitres. Cov tshuaj insulin rau kev siv kho mob yog daim ntawv tso tawm ntawm cov tshuaj dawb hygroscopic, dej-soluble hmoov.

Tam sim no tsis muaj lwm txoj kev xaiv rau kev txhaj tshuaj, lawv raug tswj ua subcutaneously, intramuscularly lossis txhaj tshuaj (tsuas yog nruab nrab, luv luv ua yeeb yam insulin hauv dej yog txhaj rau dej). Kev txhaj tshuaj subcutaneous thiab intramuscular yog muab nrog cov tshuaj insulin los yog cov tshuaj insulin. Cov cuab yeej muaj cov cuab yeej siv tau yooj yim, qhov tshuaj hormones tau qhia siv lub khawm, yog li nws tuaj yeem nqa nrog koj thiab txawm tias tus menyuam yaus muaj peev xwm muab txhaj tshuaj.

Nrog nws, tus mob ntshav qab zib tsis tuaj yeem tsuas yog muab nws tus kheej txhaj, tab sis kuj ntawm nws tus kheej koob tshuaj kom raug. Cov cuab yeej siv rov siv tau, nws ua haujlwm tsuas yog nyob rau ntawm daim ntawv kho mob qub, nws kim heev, yog li tsis yog txhua tus muaj peev xwm them taus, tshwj xeeb tshaj yog thaum koj xav tias cov neeg mob ntshav qab zib xav tau peb li cov cuab yeej no.

Kev siv tshuaj insulin hauv cov ntsiav tshuaj tsis ua rau kev siv tshuaj, vim tias daim ntawv tso tawm no tsis muaj kev cuam tshuam ntawm lub cev raws li subcutaneous, intramuscular lossis koob txhaj tshuaj. Muaj tseeb, cov kws tshawb fawb tau hais tias lawv muaj peev xwm los tsim kev noj tshuaj rau qhov ncauj tswj hwm uas yuav ua haujlwm tsis muaj qhov hnyav dua li kev txhaj tshuaj, tab sis daim ntawv tso tawm tshuaj no hauv kev sim tshuaj tseem tsis tau dhau thiab tseem tab tom txhim kho.

Keeb Kwm

Raws li kev faib tawm, cov tshuaj insulin npaj tau txawv los ntawm keeb kwm, sijhawm ua haujlwm, qib kev ua kom huv. Cov tshuaj insulin yog tsim los ntawm cov tshuaj hormones uas tau los ntawm tus txiv neej npua, tus npua thiab los ntawm cov khoom siv dag zog, ua ib qho piv txwv ntawm tib neeg lub cev. Nqaij nyoos insulin txawv ntawm tib neeg cov tshuaj hormones hauv peb cov amino acids, tom qab ntawd tuaj yeem ua rau muaj kev txhaum fab hnyav thiab ua rau muaj ntshav qab zib yav tom ntej.

Tib neeg lub cev nqus cov npua insulin zoo dua: nws txawv ntawm tib neeg cov tshuaj hormones los ntawm tsuas yog ib qho amino acid, yog li nws tsis tshua muaj allergenic, txawm hais tias nws tseem muaj cov kab mob proinsulin thiab C-peptide impurities ua rau ua xua. Yog li, tshwj xeeb tshaj yog rau cov ua xua cov neeg tsis haum lub siab, muaj kev npaj ua kom muaj cov tshuaj insulin ntau dua uas tau tsim kev txo qis qhov tshwm sim, nrog rau tib neeg cov tshuaj hormones, uas tau txais ua tsaug rau kev tsim kho caj ces (lawv hu ua "tib neeg insulin", hais txog tus kheej ua tiav).

Lub zog hluavtaws tsis muaj qhov ua xua uas ua rau muaj cov tshuaj tiv thaiv, yog li nws zoo dua los ntawm lub cev, kev ua xua rau nws yog qhov tsawg thiab cov khoom lag luam tsis muaj contraindications.

Cov tshuaj no yog tsim los ntawm cov poov xab kab mob thiab hloov kho kom zoo Escherichia coli tso rau hauv nruab nrab cov khoom noj tshwj xeeb, muaj peev xwm tsim cov tshuaj insulin rau tib neeg. Txij li thaum qhov ntau ntawm cov tshuaj tsim tawm yog qhov loj, cov kws tshawb fawb xav tawm tswv yim xav tias tsiaj insulin yuav hloov sai sai.

Lub sijhawm siv sijhawm

Kev siv tshuaj ntawm pab pawg pharmacological ntawm cov tshuaj insulin sib txawv hauv lub sijhawm ua: lawv yog luv, nruab nrab thiab ntev.Cov khoom lag luam nrog luv luv (kwv yees li rau 6 teev) yog cim los ntawm kev nrawm ntawm lub cev: lawv pib muaj kev cuam tshuam rau nws nyob rau hauv ib nrab teev tom qab kev tswj hwm thiab muaj cov txiaj ntsig siab tshaj plaws ob rau peb teev tom qab txhaj tshuaj.

Cov khoom lag luam tau faib ua cov tshuaj nruab nrab hauv nruab nrab hauv kev faib tawm muaj cov zinc, vim tias cov tshuaj hormones tawm ntau qeeb dua. Lawv pib ua tom qab - tom qab ob teev, tus nqi siab tshaj plaws tuaj yeem pom tom qab 8-14 teev, qhov cuam tshuam kav ib hnub.

Kev loj hlob ntawm cov tshuaj rau lub sijhawm ntev dua los ntawm qhov xav tau los daws cov neeg mob ntawm kev txhaj tshuaj insulin ntau zaus (li ntawm peb mus rau plaub zaug hauv ib hnub): vim tias psyche hnov mob tsis zoo rau txhua qhov kev txhaj tshuaj, thiab yog li ntawd nws ua rau mob. Ib qho ntxiv, tom qab hno tas rau ntawm thaj chaw txhaj tshuaj, hematomas tuaj yeem tsim lossis kab mob tuaj yeem nkag mus.

Qee qhov xwm txheej, cov kws kho mob qhia cov tshuaj insulin nruab nrab thiab luv ua ke. Hauv qhov no, nws raug nquahu kom yuav cov tshuaj los ntawm cov chaw tsim khoom hauv cov chaw muag tshuaj, vim tias daim ntawv tso tawm cov tshuaj los ntawm cov tuam txhab sib txawv, txawm tias lawv tsis sib txawv, yog kev txhaj tshuaj; raws li cov khoom siv, ntau yam tshuaj sib ntxiv uas yuav tsum tau los nruab nrab yog tias yuav los ntawm cov tuam txhab sib txawv.

muaj cov tshuaj insulin, lub sijhawm ua haujlwm yog li ntawm 24 txog 36 teev. Lawv pib cuam tshuam rau lub cev ob teev tom qab nkag, lub sijhawm ntawm kev ua siab tshaj yog 16-20 teev, tom qab ntawd nws pib poob qis.

Cov tshuaj no feem ntau tau tshaj tawm rau cov neeg mob uas tsis tshua nkag siab zoo rau insulin, lawv kuj yooj yim rau cov neeg laus lossis cov neeg tsis pom kev zoo uas tsis muaj peev xwm muab txhaj tshuaj rau lawv tus kheej thiab vam khom tus tuaj ntawm tus nais maum. Daim ntawv tso tawm ntawm cov tshuaj ntev tshaj tawm yog sterile 5 thiab 10 ml fwj nrog hermetically kaw roj hmab nres.

Txawm hais tias cov nyhuv ntawm cov tshuaj ua kom ntev li siv tau ntev dua, cov kws kho mob nyiam insulins luv luv thiab nruab nrab. Cov neeg mob zam rau lawv zoo dua: yog tias qhov tshwm sim ntawm kev siv tshuaj yog ntau dua nees nkaum plaub teev, thaum sawv ntxov yuav muaj teeb meem ntawm kev mob ntshav qab zib.

Txoj Kev Txais Tos

Cov tshuaj twg los ntawm pawg ntawm cov tshuaj insulin kom noj, thiab cov koob tshuaj twg, tus kws kho mob yuav tsum txiav txim siab thiab muab cov lus qhia tshwj xeeb: qhov ntsuas hauv txhua kis yog tus neeg thiab tsis muaj ib txoj kev kho. Cov theem ntawm cov piam thaj hauv cov ntshav yuav tsum tau saib xyuas tas li thiab, yog tias tsim nyog, kho kho.

Yog tias peb tham txog cov tshuaj hormones uas cov kua txiav ntawm tus neeg noj qab haus huv tsim tawm, ces nws cov nyiaj hauv ib hnub yog los ntawm 30 txog 40 units. Tib qho kev cai (los ntawm 30 txog 50 units) yog xav tau rau cov ntshav qab zib, tsis hais lub keeb kwm ntawm insulin. Hauv qhov no, 2/3 ntawm cov yuav tsum coj thaum sawv ntxov, so - thaum yav tsaus ntuj. Ua cov kev hloov pauv ntawm tsiaj mus rau tib neeg cov kua dej, raws li cov lus qhia, qhov koob tshuaj yog ib txwm txo, txij li lub cev cov tshuaj tua kab mob yog nqus tau zoo dua los ntawm lub cev.

Ntseeg tau tias cov txiaj ntsig zoo tshaj plaws tuaj yeem ua tiav los ntawm kev sib txuas nrog cov tshuaj siv tshuaj tiv thaiv luv luv thiab nruab nrab; raws li, lub sijhawm tswj kev siv tshuaj nyob ntawm nws. Ntawm cov lossis loj ntawm cov txheej txheem kev kho, cov nram qab no yog xyaum ua tam sim no:

thaum sawv ntxov thaum noj tshais, noj tshuaj nrog lub sijhawm luv luv ntawm kev coj ua, nrog rau lub sijhawm nruab nrab (yuav ua li cas, tus kws kho mob yuav qhia). Ua ntej noj hmo - ua yeeb yam luv luv, thaum hmo ntuj, thaum 22 lossis 23 teev - npaj rau nruab nrab-ntev,
insulin nrog lub sijhawm luv luv ntawm kev nqis tes ua, txhaj ua ntej noj tshais, noj su thiab noj hmo, ua ntej yuav mus pw, thaum 23 teev - insulin npaj ntawm lub sijhawm ntev lossis nruab nrab,
nruab nrab lossis ntev ntev insulin thaum kaj ntug, luv luv - ua ntej noj tshais, noj su thiab noj hmo (hom kev yooj yim dua li dhau los).

Yog tias tus kws kho mob tsuas sau ib qho tshuaj, ib qho tshuaj nrog lub sijhawm luv luv tau pom zoo kom txhaj peb zaug hauv ib hnub, ntawm qhov nruab nrab lub sijhawm - ob zaug ib hnub: kev txhaj tshuaj yuav tsum muab 45 feeb ua ntej noj tshais thiab ua ntej noj hmo. Lwm qhov taw qhia uas yuav tsum tsis txhob hnov qab thaum hais txog kev siv cov insulin yog tias cov insulin nruab nrab tuaj yeem raug txhaj tsis yog tsuas yog intramuscularly lossis subcutaneously, tab sis kuj tseem rau lub cev. Cov tshuaj ntev ntev (daim ntawv tso tawm 5 thiab 10 ml) tsis yog muab tshuaj rau hauv qhov quav.

Sab sij huam

Cov tshuaj Insulin muaj yuav luag tsis muaj qhov tsis muaj sib kis: yog tias ib qho khoom tsis haum, nws tuaj yeem hloov mus rau lwm tus, tab sis kev cuam tshuam yuav tshwm sim. Nws yog ib qho tseem ceeb hauv kev kho mob ntshav qab zib kom soj ntsuam qhov ntau npaum: txo tus kheej lossis txo qhov koob tshuaj yog txwv tsis pub siv. Ob qho tib si vim tias tsis muaj cov piam thaj thiab dhau ntawm qhov kev cai, koj tuaj yeem poob rau hauv lub cev tsis nco qab thiab tuag (raws li kev txheeb cais, plaub feem pua ntawm cov neeg mob hnub nyoog qis dua tsib caug tuag vim li no).

Lwm cov teeb meem tshwm sim yog kev ua xua, uas tuaj yeem tshwm sim ntawm insulin npaj ntawm tsiaj keeb kwm. Ntawm thawj cov tsos mob (cov tsos ntawm khaus, zuj zus ntawm kev noj qab nyob zoo), koj yuav tsum sab laj nrog kws kho mob thiab hloov mus rau tib neeg cov tshuaj insulin. Nws raug nquahu kom hloov pauv zoo li no hauv tsev kho mob nyob rau hauv kev saib xyuas ntawm tus kws kho mob, qhov twg nws yog qhov ua tau kom soj ntsuam cov qib ntawm cov piam thaj tsis tu ncua thiab kho cov koob tshuaj kom raug.

Lwm cov tshuaj tiv thaiv tuaj yeem yog atrophy lossis hypertrophy ntawm adipose nqaij ntawm qhov chaw txhaj tshuaj. Qhov teeb meem no feem ntau yog siv cov nqaij tsiaj insulin thiab tsis tshua muaj txiaj ntsig thaum siv cov tawv nqaij porcine lossis tib neeg insulin. Qhov no tsis coj ntau qhov kev puas tsuaj, tab sis thaj chaw txhaj tshuaj yuav tsum tau hloov, vim tias qhov nqus ntawm cov kua dej tsis muaj zog. Qhov no tsuas yog ua tau hauv kev sab laj nrog tus kws kho mob, vim tias txhua thaj chaw ntawm lub cev muaj qhov sib txawv ntawm cov tshuaj.

Qhov tshuaj insulin yog ib qho kev txiav ntshav qab zib. , muaj lub peev xwm los tswj cov metabolism hauv kev ua kom yuag, ua kom cov nqaij mos ntawm cov piam thaj thiab txhawb nws txoj kev hloov mus rau hauv glycogen, kuj pab txhawb kev nkag mus ntawm cov piam thaj rau hauv cov nqaij mos.
Ntxiv rau cov nyhuv hypoglycemic (txo qis ntshav qab zib), insulin muaj ntau yam teebmeem: nws nce cov nqaij glycogen khw muag khoom noj, txhawb peptide synthesis, txo kev noj protein ntau, thiab lwm yam.

Kev tsim tawm rau cov kua dej yog los nrog kev tsa los yog inhibition (inhibition) ntawm qee yam enzymes , glycogen synthetase, pyruvate dehydrogenase, hexokinase yog qhov ua kom muaj zog, lipase ua kom muaj roj ntau ntawm cov ntaub so ntswg adipose, lipoprotein lipase, txo cov ntshav txhaws tom qab noj mov ntau hauv cov rog, yog inhibited.
Qhov ntsuas ntawm biosynthesis thiab kev zais zais (tso pa tawm) ntawm cov kua dej yog nyob ntawm cov concentration ntawm cov piam thaj hauv cov ntshav.
Nrog rau kev nce ntxiv hauv nws cov ntsiab lus, pancreatic secretion ntawm cov tshuaj insulin nce, ntawm qhov tsis tooj, qhov txo qis hauv cov concentration ntawm cov piam thaj hauv cov ntshav ua rau cov kua dej insulin tsis pub tawm.

Hauv kev siv ntawm kev cuam tshuam los ntawm cov tshuaj insulin, lub luag haujlwm tseem ceeb yog ua si los ntawm nws kev sib cuam tshuam nrog ib qho tshwj xeeb receptor hauv zos ntawm lub plasma daim nyias nyias ntawm tes, thiab tsim muaj cov insulin receptor complex.
Cov tshuaj insulin hauv kev sib xyaw nrog cov tshuaj insulin nkag mus hauv lub cell , qhov twg nws cuam tshuam phospholation ntawm cov xovtooj ntawm cev, cov kev ua kom lub ntsej muag tsis tshua to taub.
Insulin yog qhov tseem ceeb tshaj plaws rau kev kho mob ntshav qab zib mellitus, vim nws txo qis hyperglycemia (kev nce ntshav hauv cov ntshav qabzib) thiab glycosuria (muaj cov piam thaj hauv cov zis), rov ua rau lub qog ntawm glycogen hauv lub siab thiab cov leeg, txo cov ntshav qabzib ntau, thiab alleviates lipemia (muaj cov rog hauv cov ntshav) , txhim kho kev mob ntawm tus neeg mob .

Cov tshuaj insulin rau kev siv kho mob yog tau los ntawm kev mob siab ntawm nyuj thiab npua Cov. Muaj txheej txheem ntawm kev ua kom muaj zog sib xyaw ntawm cov tshuaj insulin, tab sis nws nkag tsis tau.
Tsis ntev los no tsim cov txheej txheem biotechnological rau kev tsim tib neeg cov kua dej. Cov insulin tau los ntawm kev tsim hluav taws xob yog tsim los ntawm amino amino series ntawm tib neeg cov insulin.
Nyob rau hauv rooj plaub uas muaj tshuaj insulin los ntawm tus tsiaj ntawm lub cev, ntau yam tsis txaus (proinsulin, glucagon, tus kheej-statin, cov protein, polypeptides, thiab lwm yam) tuaj yeem nyob rau hauv qhov kev npaj vim muaj kev huv huv tsis txaus.
Tsis zoo lim cov tshuaj tua kab mob insulin tuaj yeem ua rau muaj kev phiv tshuaj ntau.

Cov txheej txheem niaj hnub ua rau nws muaj peev xwm ua kom tau purified (monopic - chromatographically purified nrog tso tawm ntawm "lub ncov" ntawm cov kua dej), ua kom huv (monocomponent) thiab crystallized insulin npaj.
Tam sim no, crystalline tib neeg cov tshuaj insulin yog nce siv.
Ntawm insulin npaj ntawm tsiaj keeb kwm, kev nyiam yog muab rau cov tshuaj insulin uas tau los ntawm kab mob qog npua ntawm npua.

Cov kev ua haujlwm ntawm insulin yog txiav txim siab biologically (los ntawm kev muaj peev xwm txo cov ntshav qab zib hauv luav zoo) thiab ib qho kev qhia ntawm lub cev (electrophoresis rau ntawm daim ntawv lossis cov ntawv chromatography ntawm daim ntawv). Rau ib chav ua haujlwm (UNIT), lossis chav thoob ntiaj teb (IE), coj cov haujlwm ntawm 0.04082 mg ntawm cov kua roj insulin crystalline.

Qhov tseem ceeb qhia txog kev siv tshuaj insulin yog hom I ntshav qab zib mellitus (insulin-dependant), tab sis nyob rau qee qhov xwm txheej nws kuj tau sau tseg rau hom II mob ntshav qab zib mellitus (non-insulin-dependant).

Hauv kev kho mob ntshav qab zib siv cov tshuaj insulin npaj ntawm cov sijhawm ua haujlwm sib txawv .
Cov tshuaj insulin luv luv kuj tseem nyob hauv qee lwm cov txheej txheem pathological ua rau lub xeev hypoglycemic (txo qis ntshav qab zib) hauv qee yam mob schizophrenia, raws li tus neeg anabolic (txhim kho protein synthesis) tus neeg sawv cev nrog kev tso pa tawm dav dav, tsis muaj zaub mov noj, furunculosis (ntau yam purulent o ntawm daim tawv nqaij), thyrotoxicosis (mob qog) mob qog), hauv cov kab mob ntawm lub plab (atony / poob suab / / mob plab / mob plab / prolapse ntawm lub plab /), mob siab ntev (mob rau daim siab ua mob), pib ua mob rau daim siab ua paug, thiab tivthaiv "polarizing" dlaws siv los kho mob coronary insufficiency (mismatch ntawm mob oxygen thov thiab nws tus me nyuam).

Kev xaiv cov tshuaj insulin rau kev kho mob ntshav qab zib yog nyob ntawm qhov mob hnyav thiab cov yam ntxwv ntawm cov chav kawm ntawm tus kab mob, qhov xwm txheej dav dav ntawm tus neeg mob, nrog rau kev ceev ntawm qhov pib thiab lub sijhawm ntawm cov nyhuv hypoglycemic ntawm cov tshuaj.
Qhov tau teem caij xub thawj ntawm cov tshuaj insulin thiab tsim kev txhaj tshuaj yog zoo dua nqa tawm hauv tsev kho mob (tsev kho mob).

Kev npaj ua yeeb yam luv luv - cov no yog cov kev daws teeb meem rau subcutaneous lossis intramuscular thawj coj.
Yog tias tsim nyog, lawv kuj raug tswj hwm hauv lub cev khov kho.
Lawv muaj qhov nrawm nrawm thiab luv luv cov suab thaj txo cov nyhuv.
Feem ntau lawv muab tshuaj subcutaneously lossis intramuscularly 15-20 feeb ua ntej noj mov los ntawm ib qho mus rau ntau zaus thaum nruab hnub.
Cov nyhuv tom qab txhaj tshuaj subcutaneous tshwm sim hauv 15-20 feeb, nce mus txog qhov siab kawg tom qab 2 teev, tag nrho lub sijhawm ntawm kev txiav txim tsis tshaj 6 teev.
Lawv siv feem ntau hauv tsev kho mob los tsim cov koob tshuaj insulin tsim nyog rau tus neeg mob, nrog rau cov xwm txheej uas yuav tsum tau ua tiav ntawm kev hloov pauv sai sai hauv lub cev - nrog rau cov ntshav qab zib tsis nco qab thiab precom (ua tiav lossis ib feem ntawm qhov tsis nco qab vim muaj cov ntshav qab zib sai sai) Cov.
Tsis tas li ntawd, kev npaj tshuaj insulin luv luv yog siv los ua tus neeg sawv cev anabolic thiab raug xaj, raws li txoj cai, hauv kev txhaj tshuaj me (4-8 units 1-2 zaug hauv ib hnub).

Siv sijhawm ntev (ua haujlwm ntev) insulin npaj muaj nyob rau hauv ntau daim ntawv qhia cov tshuaj sib txawv muaj qhov sib txawv ntawm cov suab thaj txo cov txiaj ntsig (semylong, ntev, ultralong).
Rau cov tshuaj sib txawv, cov nyhuv kav ntev li 10 mus rau 36 teev.
Ua tsaug rau cov tshuaj no, koj tuaj yeem txo qis cov tshuaj txhaj txhua hnub.
Lawv feem ntau tsim tawm hauv kev ncua hauv kev ncua. (kev txwv ntawm cov khoom tsis zoo ntawm cov tshuaj hauv cov kua), tswj kev tsuas yog subcutaneously lossis intramuscularly, kev tso ntshav tshuaj tsis pub. Hauv kev mob ntshav qab zib tsis nco qab thiab precomatous, ntev lub sij hawm cov tshuaj tsis siv.

Thaum xaiv cov tshuaj insulin, nws yog ib qho tsim nyog yuav tsum xyuas kom meej tias lub sijhawm ntawm cov txiaj ntsig qab zib kom qis tshaj plaws yuav ua rau lub sijhawm koj noj nws.
Yog tias tsim nyog, 2 cov tshuaj ntawm qhov kev txiav txim siab ntev tuaj yeem muab rau hauv ib leeg.
Qee tus neeg mob yuav tsum tsis ntev xwb, tab sis kuj tseem ceev ceev ntawm cov ntshav qabzib hauv cov ntshav. Lawv yuav tsum sau cov tshuaj insulin ntev thiab luv luv.
Feem ntau cov tshuaj muaj yeeb ntev li tau muab ua ntej noj tshais txawm li cas los xij, yog tias tsim nyog, kev txhaj tshuaj tuaj yeem ua tiav nyob rau lwm lub sijhawm.

Txhua qhov kev npaj rau insulin yog siv ua raws kev noj haus.
Lub ntsiab lus ntawm lub zog nqi sau (los ntawm 1700 txog 3000 khal) yuav tsum txiav txim siab los ntawm tus neeg mob lub cev qhov hnyav thaum lub sijhawm kho, los ntawm hom haujlwm. Yog li, nrog kev noj zaub mov kom tsawg thiab ua kom lub cev muaj zog, tus naj npawb ntawm cov calories uas yuav tsum tau nyob rau ib hnub rau tus neeg mob yog tsawg kawg 3000, nrog kev noj zaub mov ntau dhau thiab kev ua neej nyob rau sedentary, nws yuav tsum tsis pub tshaj 2000.

Cov kev qhia ntawm kev noj tshuaj ntau dhau lawm, nrog rau qhov tsis muaj kev noj haus ntawm cov carbohydrates nrog zaub mov, tuaj yeem ua rau lub xeev hypoglycemic (txo cov ntshav qab zib) nrog rau kev xav txog kev tshaib plab, tsis muaj zog, tawm hws, tshee tshee ntawm lub cev, mob taub hau, kiv taub hau, mob caj dab, mob euphoria (causeless kev txaus siab) lossis kev txhoj puab heev.
Tom qab, hypoglycemic coma yuav tshwm sim (tsis nco qab, tus yam ntxwv ua tiav ntawm qhov tsis txaus ntawm lub cev rau qhov kev xav sab nraud vim tias qhov txo qis hauv cov ntshav qab zib) nrog poob ntawm kev nco qab, qaug dab peg, thiab ib qho kev poob ntawm lub plawv dhia.
Txhawm rau tiv thaiv lub xeev hypoglycemic, cov neeg mob yuav tsum haus dej qab zib lossis noj ob peb daim qab zib.

Nrog hypoglycemic (cuam tshuam nrog ib tug txo nyob rau hauv cov ntshav qab zib) coma 40% kua nplaum tov yog tso rau hauv cov leeg hauv qhov nyiaj ntawm 10-40 ml, qee zaum txog li 100 ml, tab sis tsis muaj ntxiv.
Kev kho cov ntshav qog ntshav qab zib (txo cov ntshav qab zib) hauv cov mob hnyav tuaj yeem nqa tawm ntawm kev siv tshuaj intramuscular lossis subcutaneous ntawm glucagon.

Nrog kev tswj hwm ntawm subcutaneous ntawm insulin npaj, lipodystrophy (txo qis ntawm adipose nqaij hauv cov nqaij subcutaneous) yuav tshwm sim ntawm qhov chaw txhaj tshuaj.

Kev kho mob zoo yog qhov yuav tsum tau ua hauv kev kho mob ntawm cov neeg mob ntshav qab zib mellitus, kev txom nyem los ntawm kev txhim kho lub plawv tsis txaus (ib qho tsis sib xws ntawm lub siab xav tau oxygen thiab nws txoj kev xa mus) thiab lub hlwb puas | ntshav ncig.
Ceev faj yog qhov tsim nyog thaum siv tshuaj insulin hauv cov neeg mob qog mob qog, Addison's mob (kev ua tsis txaus adrenal), thiab lub raum tsis ua haujlwm.

Cev xeeb tub insulin kho yuav tsum tau saib xyuas kom zoo.
Nyob rau thawj peb lub hlis thaum cev xeeb tub, qhov xav tau rau insulin feem ntau poob qis me ntsis thiab nce hauv lub thib ob thiab thib peb feem plaub.
Alpha-adrenergic blockers thiab beta-adrenostimulants, tetracyclines, salicylates nce lub zais ntawm cov endogenous (kev ua haujlwm ntawm lub cev tsim) insulin.
Thiazide diupetics (diuretics), beta-blockers, cawv tuaj yeem ua rau cov ntshav qab zib tsawg.

Sib cuam tshuam nrog
lwm yam tshuaj ntsuab
los ntawm txoj kev:

Kev ua haujlwm hypoglycemic ntawm insulin yog kho dua qhov ncauj hypoglycemic tshuaj, Mao inhibitors, ACE inhibitors, carbonic anhydrase inhibitors, xim beta-blockers, bromocriptine, octreotide, sulfonamides, anabolic steroids, tetracyclines, clofibrate, ketoconazole, mebendazole, pyridoxine, theophylline, cyclophosphamide, fenfluramine, lithium, tshuaj muaj ethanol Cov.

Hypoglycemic nyhuv ntawm insulin tsis muaj zog cov tshuaj tiv thaiv tsis haum, tshuaj corticosteroids, cov thyroid hormones, thiazide diuretics, heparin, tricyclic antidepressants, sympathomimetics, danazole, clonidine, calcium channel blockers, diazoxide, morphine, phenytoin, nicotine.

Nyob rau hauv kev cuam tshuam ntawm reserpine thiab salicylates, ob qho tib si ua rau qaug zog thiab nce ntxiv hauv kev ua ntawm cov tshuaj muaj peev xwm ua tau.
Cov tshuaj muaj thiol lossis sulfite, thaum ntxiv rau hauv insulin, ua rau nws rhuav tshem.

Thaum cev xeeb tub, hom tshuaj insulin, nws cov koob tshuaj thiab kev tswj hwm yog txiav txim los ntawm tus kws kho mob koom nrog.
Yog hais tias qhov pib xaiv qhov tseeb ntawm kev kho mob tsis haum, nws yog qhov yuav tsum tau sab laj nrog tus kws kho mob dua thiab xaiv, qhov kawg, qhov yooj yim tshaj plaws thiab kev ua haujlwm ntawm kev kho mob.

Cov tsos mob : cov leeg tsis muaj zog, lub teeb ua kom tsis muaj zog, kev tshaib kev nqhis, kev hais lus tsis zoo, pallor, loog ntawm cov ntiv tes, tshee tshee, ua rau lub ntsej muag, lub ntsej muag, qhov muag plooj, mob taub hau, nquag quaj, zom, ua kom yoog, tsis nco qab, tsim txom los sis ntxhov siab, kev ua tsis tau, tonic lossis clonic. thiab thaum kawg, coma.

Kev kho mob rau qhov mob hypoglycemic yuav tsum tau pib tam sim ntawd.
Hauv cov xwm txheej me, nws yog qhov txaus kom muab sab hauv tshuaj yej qab zib, kua txiv, kua zib ntab.
Nrog kev ua tiav ntawm kev tsis nco qab (tsis nco qab lawm) tam sim ntawd hno cov kua qab zib (10-20 ml ntawm 20-40% piam thaj).
Yog tias tsis muaj qhov xav tau ntawm kev txhaj tshuaj rau cov ntshav qabzib, nws raug pom zoo kom tswj hwm 0.001-0.002 g ntawm glucagon lossis 0.5 ml ntawm 0.1% daws ntawm adrenaline hydrochloride hauv qab daim tawv nqaij.
Nws yuav tsum tau yug los rau hauv lub siab tias nrog kev qhia txog adrenaline, kev mob tshwm sim tuaj yeem tshwm sim - palpitations, tshee tshee, nce ntshav siab, ntxhov siab, thiab lwm yam.

Syringe insulin muaj nyob rau hauv cov iav vials kaw nrog roj hmab nres nrog cov txhuas tawg-rau.
Hauv cov hwj 10 ml, hauv ib lub thawv 5 pcs lossis hauv penfill (cartridges) 1.5 thiab 3 ml rau koob txhaj tshuaj .

Cov tshuaj insulin (ob lub vials thiab daim cartridges) uas tsis siv, yuav tsum muab cia rau 2-8 ° C hauv qhov chaw tsaus , i.e. hauv lub tub yees (zoo dua rau hauv qab txee), deb ntawm lub tub yees.
Ntawm qhov ntsuas kub no, lawv khaws lawv cov khoom siv roj ntsha thiab aseptic kom txog thaum txee lub neej qhia ntawm pob. Yuav tsum tsis muaj cov tshuaj insulin thaum ya nrog lub dav hlau kom tsis txhob muaj qhov txaus ntshai ntawm kev ua kom txias.
Kub dhau lawm cia qhov kub yuav ua rau txo qis qis hauv kev ua haujlwm lom neeg hauv tshuaj. Kev tshav ntuj ncaj qha tseem cuam tshuam cuam tshuam, nrawm dua qhov ploj ntawm cov kev ua lom neeg los ntawm 100 zaug.
Cov pob tshab kua dej ua kom tsis haum yuav ua rau muaj zog thiab ua huab Cov. Granules thiab flakes daim ntawv hauv ib qho kev ncua ntawm cov kua dej. Kev sib xyaw ua ke ntawm tshav kub thiab lub caij nyoog sib cais ua rau nrawm txheej txheem no.

Lub khob tshuaj insulin uas tus neeg mob siv tau tuaj yeem khaws cia hauv chav tsev tsis pub dhau 25 ° C, hauv qhov chaw tsaus txog li 6 lub lis piam. Lub sijhawm no raug txo mus rau 4 lub lis piam thaum siv Penfill cartridges, vim tias cov koob txhaj tshuaj syringe feem ntau nqa hauv koj lub hnab ris thaum kub ze rau lub cev kub. Vials ntawm cov tshuaj insulin tuaj yeem muab cia rau hauv tub yees rau 3 lub hlis tom qab thawj zaug siv thawj zaug.

Siv dej khov insulin tsis tuaj yeem siv tom qab yaj tas. Nov yog qhov tseeb tshwj xeeb rau kev ncua. Thaum lub sijhawm ua kom khov, muaju lossis lwm cov txheej txheem sib sau thiab tsis yaj tom qab yaj, uas ua rau nws tsis tuaj yeem ua kom tsis muaj kev txwv lub tsev kawm ntawv dua. Yog li, qhov txaus ntshai ntawm kev qhia txog cov tshuaj tsis txaus ntseeg tau nce ntau.

Cov tshuaj insulin yuav tsum raug txiav txim siab tom qab yaj. Tsis siv cov kab mob insulin thaum hloov kho, ua kom lub cev lossis cov tsos ntawm cov khoom tawg uas tau muab tshem tawm.
Kev tshem tawm tshuaj insulin, uas tom qab sib tov tsis ua rau qhov sib cais tsis ntwm los yog muaj lumps, fibers, hloov xim, tsis zoo rau kev siv.

1 ml ntawm kev daws lossis ncua kev kawm feem ntau muaj 40 units.
Ua raws li cov peev txheej ntawm cov khoom tsim tawm, cov kua dej insulin yog cais tawm ntawm cov tsiaj ua kua thiab ua kom sib xyaw ua ke siv cov txheej txheem engineering tsim.

Raws li cov neeg kawm ntawv ntawm kev ua kom huv, kev npaj tshuaj insulin los ntawm cov tsiaj cov nqaij tau muab faib ua monopic (MP) thiab monocomponent (MK).
Tam sim no tau los ntawm npua npua, lawv muaj ntxiv nrog rau tsab ntawv C (SMP - nqaij npuas monopic, SMK - nqaij npuas monocomponent), nyuj - tsab ntawv G (nqaij nyug: GMP - nqaij nyuj monopick, GMK - nqaij nyug monocomponent).
Kev tiv thaiv tib neeg ntawm insulin yog qhia los ntawm tsab ntawv C.

Ua raws li lub sijhawm ua ntawm kev ua, insulins tau muab faib ua:
- Kev npaj tshuaj insulin luv luv : pib ntawm kev ua tom qab 15-30 feeb, qhov kawg siab ua tom qab 1 / 2-2 teev, tag nrho lub sijhawm ntawm kev txiav txim 4-6 teev,
- ntev insulin npaj suav nrog cov tshuaj uas muaj qhov nruab nrab ntawm kev ua (pib tom qab 1 / 2-2 teev, ncov tom qab 3-12 teev, tag nrho lub sijhawm 8-12 teev), tshuaj nrog ntev ntev (pib tom qab 4-8 teev, ncov tom qab 8-18 teev, tag nrho lub sijhawm 20-30 teev).

Niaj hnub no, kev lag luam kws kho mob tsim tawm ntau hom tshuaj insulin. Tam sim no, ntau hom tshuaj insulin siv rau hauv cov tshuaj.

Cov pab pawg ntawm insulins feem ntau txiav txim siab nyob ntawm lub sijhawm ntawm lawv cov kev coj tom qab kev tswj hwm mus rau tib neeg lub cev. Hauv tshuaj, tshuaj ntawm lub sijhawm hauv qab no yog qhov txawv:

ua vauv
luv
nruab nrab ncua sijhawm ua
yeeb tshuaj ntev.

Kev siv ntawm ib lossis lwm hom insulin yog nyob ntawm tus neeg tus yam ntxwv ntawm tus neeg mob thiab kev coj tus mob ntshav qab zib mellitus txoj kev kho nrog insulin.

Qhov sib txawv ntawm cov tshuaj insulin sib txawv los ntawm txhua qhov sib txawv hauv qhov muaj pes tsawg leeg thiab hauv cov qauv txheej txheem. Rau txhua hom kev npaj tshuaj insulin, cov lus qhia rau kev siv yog tsim kho raws li cov yam ntxwv ntawm cov muaj pes tsawg leeg thiab txoj kev npaj.

Tsis tas li ntawd, muaj cov kev cai dav dav uas yuav tsum tau ua thaum ua kev kho cov tshuaj insulin. Txhua cov tshuaj insulin muaj qee qhov ntsuas thiab contraindications rau siv.

Cov chaw muag tshuaj

Detemir insulin yog soluble basal analogue ntawm tib neeg cov tshuaj insulin, lub caij nyoog ntev nrog ib daim ntawv tiaj tiaj ntawm kev nqis tes ua, uas yog tsim los ntawm recombinant DNA biotechnology siv Saccharomyces cerevisiae hom. Cov tshuaj insulin khi rau cov receptors tshwj xeeb, yog li kev kho kom haum xeeb los ntawm cov roj ntsha. Cov tshuaj insulin tswj cov metabolism hauv qabzib. Nws txo cov ntshav qabzib hauv cov ntshav, txhawb nws kev noj los ntawm lub cev nqaij thiab inhibiting gluconeogenesis. Cov tshuaj Insulin pab txhim kho cov protein biosynthesis, inhibits proteolysis thiab lipolysis hauv cov rog rog. Qhov siab tshaj plaws ntawm detemir insulin hauv cov ntshav cov ntshav tau mus txog tom qab 6 - 8 teev tom qab kev tswj hwm. Nrog rau kev tswj hwm ntawm kev coj noj coj ua ob zaug hauv ib hnub, kev ua kom tiav ntawm cov tshuaj insulin Detemir hauv cov ntshav cov ntshav tau ua tiav tom qab 2 rau 3 hno. Kev nkag siab ntawm kev hloov pauv ntawm cov tshuaj insulin muaj qis dua thaum piv nrog lwm cov kev npaj tshuaj insulin. Hauv pharmacokinetics ntawm insulin detemir, tsis muaj qhov sib txawv tseem ceeb hauv tsev kho mob txawv. Qhov nruab nrab ntawm qhov kev faib tawm ntawm insulin detemir yog kwv yees li 0.1 l / kg. Kev ua tsis tiav ntawm insulin detemir zoo ib yam li tib neeg kev npaj insulin, tag nrho cov khoom lag luam metabolic tsis ua haujlwm. Tsis muaj kev sib cuam tshuam hauv chaw khomob yog qhov tseem ceeb ntawm insulin detemir thiab cov roj ntsha lossis lwm yam tshuaj uas cuam tshuam rau cov protein. Ib nrab-lub neej kawg nrog kev txhaj tshuaj subcutaneous yog nyob ntawm qhov koob tshuaj thiab qib ntawm nqus los ntawm cov nqaij mos subcutaneous thiab yog 5 txog 7 teev.

Mob ntshav qab zib mellitus hauv cov neeg mob laus dua 2 xyoos.

Tsuas tshuaj ntawm cov insulin detemir thiab koob tshuaj

Detemir insulin tsuas yog npaj rau kev coj ua subcutaneous, cov tshuaj tsis tuaj yeem raug tswj tshuaj, vim tias qhov no tuaj yeem ua rau mob ntshav qab zib tsis txaus. Cov koob tshuaj tau txiav txim siab raws li qhov xav tau ntawm tus neeg mob. Koob tshuaj yuav tau noj yog hais tias tus neeg mob ib txwm noj zaub mov hloov, nws kev ua si ntau zog, lossis mob concomitant. Detemir insulin tuaj yeem siv tau ob qho tib si hauv kev tsim tshuaj monotherapy thiab nrog bolus insulin, zoo li nrog hypoglycemic tshuaj rau kev tswj hwm ntawm qhov ncauj. Detemir insulin tuaj yeem siv tau thaum lub sijhawm yoojyim thaum nruab hnub, tab sis tom qab teeb tsa lub sijhawm txhaj, koj yuav tsum ua raws li nws txhua hnub. Detemir insulin yog hno subcutaneously rau hauv thaj av ntawm sab xub ntiag phab ntsa, ncej puab, xub pwg, gluteal lossis deltoid cheeb tsam. Qhov chaw txhaj tshuaj yuav tsum tau hloov ua ntu zus kom txo tau kev pheej hmoo ntawm lipodystrophy. Ib yam li lwm txoj kev npaj tshuaj insulin, hauv cov neeg laus thiab cov neeg mob lub raum lossis lub cev tsis ua haujlwm zoo, ua tib zoo saib xyuas cov ntshav qabzib ntau ntau thiab kho cov koob tshuaj detemir ib leeg zuj zus. Ib yam li lwm txoj kev npaj tshuaj insulin, nws raug nquahu kom koj saib xyuas cov ntshav qabzib thaum lub sijhawm txhais lus thiab hauv thawj asthiv ntawm kev muab tshuaj tshiab.
Detemir insulin muaj qhov ua kom ntev (txog li ib hnub).
Detemir insulin kho tsis ua rau lub cev hnyav.
Ua ntej taug kev ntev ntev, uas cuam tshuam nrog kev hloov sijhawm hauv thaj chaw, tus neeg mob yuav tsum sab laj nrog koj tus kws kho mob, vim tias hloov sijhawm caij nyoog txhais tau tias tus neeg mob yuav txhaj tshuaj insulin thiab noj rau lwm lub sijhawm.
Kev tsis tu ncua ntawm kev kho lossis tsis txaus noj tshuaj yuav ua rau hyperglycemia lossis ntshav qab zib ketoacidosis. Hyperglycemia feem ntau loj hlob maj mam dhau ob peb teev lossis hnub. Cov tsos mob ntawm hyperglycemia suav nrog tso zis ntau zaus, nqhis dej, xeev siab, ntuav, liab thiab ntawm daim tawv nqaij, nkees nkees, lub qhov ncauj qhuav, tsis hnov ntxhiab ntawm cov acetone hauv kev ua pa, tsis qab los. Yog tias tsis muaj kev kho kom haum, hyperglycemia ua rau ketoacidosis uas mob ntshav qab zib thiab ploj tuag.
Kev mob ntshav qab zib tsawg tuaj yeem tsim kho nrog lub cev tsis tau npaj lub cev qoj ib ce lossis hla zaub mov yog tias cov koob tshuaj ntshav tsis txaus ua rau muaj qhov xav tau ntawm insulin. Thaum them nyiaj rau cov pluas noj carbohydrate hauv cov neeg mob, lawv cov tsos mob tshwm sim-kev qhia ua ntej ntawm hypoglycemia yuav hloov, cov neeg mob yuav tsum paub txog qhov no. Nrog rau cov mob ntshav qab zib ntev ntev, cov tsos mob tshwm sim ua ntej yuav ploj mus.
Cov kab mob nyuaj, tshwj xeeb tshaj yog nrog kub taub hau thiab kis kab mob, feem ntau ua rau lub cev xav tau cov tshuaj insulin.
Qhov kev hloov kho ntawm cov tshuaj insulin kuj tseem xav tau yog tias tus neeg mob tau muaj cov kab mob ntawm daim siab, lub raum, cov qog adrenal, cov thyroid caj pas, cov qog pituitary.
Muaj cov ntawv tshaj tawm txog kev txhim kho kev mob plawv tsis zoo hauv kev kho mob ntawm cov neeg mob thiazolidinediones nrog rau kev npaj tshuaj insulin, tshwj xeeb tshaj yog tias tus neeg mob muaj kev pheej hmoo rau kev txhim kho mob plawv tsis ua haujlwm. Qhov tseeb no yuav tsum raug coj los txiav txim siab thaum kho mob rau cov neeg mob ua ke nrog kev kho mob nrog insulin npaj thiab thiazolidinediones. Nrog rau kev kho mob sib xyaw ua ke no, nws yog ib qhov tsim nyog los ua kev soj ntsuam kev kho mob ntawm cov neeg mob kom paub lawv cov tsos mob thiab cov tsos mob ntawm lub plawv tsis ua hauj lwm ntev, muaj nyob ntawm edema, qhov hnyav nce. Yog tias cov tsos mob ntawm lub plawv tsis ua haujlwm tau txheeb pom los yog ua tsis zoo, kev kho mob thiazolidinedione yuav tsum tsis ua mus ntxiv.
Nrog lub ntsej muag hypoglycemia, uas tuaj yeem tsim kho thaum noj Detemir, qhov tshuaj tiv thaiv ceev thiab lub peev xwm mloog zoo yog cuam tshuam. Yog li ntawd, nrog nws txoj kev txhim kho, cov neeg mob yuav tsum yauv tsum tsis txhob koom nrog kev ua si uas ua rau muaj kev saib xyuas ntau dua thiab nrawm dua ntawm cov kev xav ntawm psychomotor (nrog rau kev tsav tsheb).

Cev xeeb tub thiab lactation

Thaum siv cov tshuaj thaum cev xeeb tub, nws yog ib qho tsim nyog yuav tsum coj mus rau hauv tus lej qhov txiaj ntsig ntawm leej niam thiab qhov muaj feem yuav ua rau muaj menyuam hauv plab. Hauv ib qho kev sim kho mob hauv tsev kho mob, tsis muaj qhov sib txawv hauv cov txiaj ntsig ntawm cev xeeb tub, hauv kev nyab xeeb tag nrho lub sijhawm thaum cev xeeb tub, hauv kev noj qab haus huv ntawm tus menyuam yug thiab tus menyuam hauv kev sib piv thaum muaj tshuaj insulin nrog detemir thiab insulin aspart. Cov lus qhia ntxiv txog kev nyab xeeb thiab muaj txiaj ntsig ntawm kev kho tshuaj thaum lub sijhawm siv tom qab muag tshaj tawm tias tsis muaj qhov tshwm sim tsis zoo uas tuaj yeem ua rau lub cev tsis huv lossis ua rau muaj mob rau cov menyuam hauv plab. Hauv cov tsiaj, pom cov yeeb tshuaj lom rau cov tshuaj ntawm lub cev txuas ntxiv tsis tau kuaj pom. Cov poj niam cev xeeb tub uas muaj ntshav qab zib yuav tsum ua tib zoo saib xyuas thoob plaws hauv lawv lub cev xeeb tub, nrog rau lub sijhawm kev npaj cev xeeb tub. Hauv thawj peb lub hlis thaum cev xeeb tub, xav tau cov tshuaj insulin feem ntau poob qis thiab lub hnub nyoog nyob rau hauv lub caij nyoog thib ob thiab thib peb. Qhov xav tau tshuaj insulin tom qab yug menyuam sai sai rov qab los rau theem uas yog ua ntej kev xeeb tub. Tsis muaj ntaub ntawv xov xwm txog ntawm seb insulin nkag mus rau Detemir rau hauv leej niam cov kua mis. Nws xav tias cov tshuaj tsis cuam tshuam rau cov metabolism hauv lub cev ntawm cov menyuam mos thaum lub sijhawm pub niam mis, txij li cov tshuaj yog peptide uas tau yooj yim rau txoj hnyuv mus rau hauv cov amino acids uas nqus tau los ntawm lub cev. Hauv lub sijhawm lub sijhawm pub mis niam hauv cov pojniam, yuav tsum tau kho cov pluas noj haus thiab koob tshuaj insulin.

Phiv los ntawm insulin detemir

Kev ntshaib plab metabolic: hypoglycemia (cov tsos mob ntawm tus mob ntshav qab zib tsawg: hws khaub thuas txias, ntxiv kev qaug zog, pallor ntawm daim tawv nqaij, tshee tshee, poob siab, ntxhov siab, tsis muaj zog, txawv txawv, nkees, tsaug zog, poob siab, poob siab heev, mob taub hau, xeev siab, tsis pom kev, ua rau lub ntsej muag), tsis nco qab, tsis meej pem, ib ntus lossis tsis tuaj yeem cuam tshuam ntawm lub hlwb kev ua haujlwm, kev tuag).
Kev ntshawv siab thiab kev tsis haum ntawm qhov chaw txhaj tshuaj: cov kev hloov pauv ntawm cov mob ntshav hauv lub cev (o, liab, khaus ntawm qhov chaw txhaj tshuaj), lipodystrophy, edema.
Lub cev tsis muaj zog tiv thaiv kab mob: urticaria, kev tsis haum tshuaj, tawm pob ntawm daim tawv nqaij, khaus, tawm hws, angioedema, mob plab, ua tsis taus pa, ua pa nyuaj, txo cov ntshav siab.
Pom kev tsis txaus ntseeg: cov mob tsis haum siab, mob ntshav qab zib ua kom rov zoo nkauj dua.
Mob leeg: peripheral neuropathy.

Kev cuam tshuam ntawm insulin detemir nrog lwm yam tshuaj

Muaj tshuaj uas cuam tshuam rau kev xav tau cov tshuaj insulin. Cov nyhuv hypoglycemic ntawm insulin yog attenuated los ntawm glucocorticosteroids, tshuaj tiv thaiv qhov ncauj, iodine-muaj cov thyroid hormones, thiazide diuretics, somatropin, heparin, sympathomimetics, tricyclic antidepressants, danazole, qeeb calcium calcium blockers, clonidine, diafin oxide,. Cov nyhuv hypoglycemic ntawm insulin yog txhim kho los ntawm monoamine oxidase inhibitors, qhov ncauj tshuaj hypoglycemic, angiotensin hloov enzyme inhibitors, tsis xaiv-beta-blockers, carbonic anhydrase inhibitors, bromocriptine, anabolic steroids, sulfonamide tshuaj, tetracycline phospholife, phenol phospholife uas muaj ethanol. Octreotide thiab lanreotide ob leeg tuaj yeem txo qis thiab ua kom lub cev xav tau cov tshuaj insulin. Nyob rau hauv kev txiav txim ntawm salicylates thiab reserpine, ob qho tib si nce thiab qhov qaug zog ntawm kev ua ntawm cov tshuaj muaj peev xwm ua tau. Cov cawv yuav muaj peev xwm thiab ua kom ntev ntev ntawm qhov kev ua kom lub ntsej muag muaj zog ntawm insulin. Beta-blockers tuaj yeem npog cov tsos mob ntawm cov qog ntshav qab zib thiab kev ncua sijhawm rov ua dua tom qab ua kom ntshav qab zib tsawg. Qee cov tshuaj, piv txwv, uas muaj cov pab pawg sulfite lossis thiol, thaum ntxiv rau hauv insulin, detemir tuaj yeem rhuav tshem nws. Detemir insulin yuav tsum tsis txhob ntxiv rau kev daws teeb meem.

Noj ntau dhau

Cov koob tshuaj tshwj xeeb uas kev noj tshuaj ntau dhau ntawm insulin detemir tsis tau tsim, tab sis ntshav qab zib ntshav qab zib tuaj yeem tsim muaj maj mam nrog kev qhia txog kev txhaj tshuaj ntau rau cov neeg mob tshwj xeeb. Kev Kho Mob: tus neeg mob tuaj yeem tshem tawm cov ntshav qab zib tsawg ntawm nws tus kheej los ntawm kev noj cov piam thaj, piam thaj, thiab zaub mov ntau hauv carbohydrates. Yog li, cov neeg mob ntshav qab zib yuav tsum nqa cov khoom qab zib, qab zib, kua txiv qab zib, ncuav qab zib.
Hauv hypoglycemia heev, thaum tus neeg mob tsis nco qab, nws yog ib qho tsim nyog yuav tau txhaj 0.5 - 1 mg ntawm glucagon subcutaneously lossis intramuscularly, lossis txhaj ib qho kev daws teeb meem ntawm cov piam thaj (dextrose) txhaj tshuaj. Nws kuj tseem ceeb rau kev tswj cov piam thaj hauv ntshav yog tias tus neeg mob tsis rov qab nco qab 10 mus rau 15 feeb tom qab cov tshuaj glucagon tswj. Thaum rov qab nco qab txog kev tiv thaiv kom tsis txhob rov mob ntshav qab zib, tus neeg mob tau pom zoo kom noj zaub mov uas muaj cov khoom noj khoom haus carbohydrates.

Tshuaj insulin yog dab tsi?

Qhov tshuaj insulin yog protein-peptide npaj ntawm keeb kwm keeb kwm. Cov tshuaj insulin yog siv los ua tus cuab yeej tshwj xeeb hauv kev kho mob ntshav qab zib.

Cov tshuaj insulin yog ib yam tshuaj uas ua kom mob plab zom mov thiab ua kom cov ntshav qabzib tsawg nyob hauv tus neeg mob ntshav ntshav. Txo cov carbohydrates hauv cov ntshav yog ua tiav los ntawm kev nce ntawm kev noj cov piam thaj los ntawm insulin-cov nqaij ua kua ntswg nyob rau hauv kev cuam tshuam ntawm insulin. Cov tshuaj Insulin pab rau kev sib sau ntawm glycogen los ntawm daim siab mob hlwb thiab tiv thaiv kev hloov pauv ntawm cov rog thiab cov amino acids rau hauv carbohydrates.

Nrog rau cov tsis muaj cov tshuaj insulin hauv tib neeg lub cev, kev nce siab ntxiv hauv cov ntshav qab zib yog tau pom. Ib qho kev nce ntxiv hauv cov ntshav qabzib provokes qhov kev loj hlob ntawm cov ntshav qab zib mellitus thiab cov teeb meem ntsig txog. Cov tshuaj insulin tsis txaus ntseeg hauv lub cev tshwm sim los ntawm qhov tshwm sim ntawm kev txiav txim siab hauv lub cev, uas tshwm sim vim yog qhov ua haujlwm tsis zoo ntawm cov kab mob endocrine, tom qab raug mob lossis nrog lub zog ntawm lub hlwb ntawm lub cev cuam tshuam nrog qhov tshwm sim ntawm kev ntxhov siab.

Kev npaj muaj cov tshuaj insulin yog tsim los ntawm tsiaj cov tawv nqaij caj dab.

Feem ntau, kev tsim cov tshuaj siv cov ntaub so ntswg ntawm cov neeg mob tawv nqaij thiab npua.

Kev taw qhia rau kev siv cov tshuaj insulin

Txhawm rau tshem tawm kev siv tshuaj ntau dhau ntawm cov tshuaj insulin, nws yuav tsum noj 100 grams ntawm cov khob cij dawb, tshuaj yej qab zib lossis ob peb dia suab thaj ntawm thawj cov tsos mob ntawm kev tsuas tshuaj.

Nyob rau hauv muaj cov cim qhia ntawm kev poob siab, qabzib yuav tsum muab rau tus neeg mob tso ntshav. Yog tias tsim nyog, koj tuaj yeem ua ntxiv siv adrenaline subcutaneously.

Yuav tsum tau ceev faj tshwj xeeb yog siv cov tshuaj insulin hluavtaws hauv cov neeg mob ntshav qab zib mellitus, nyob rau ntawm kev mob ntshav siab tsis txaus thiab kev kuaj pom kev puas tsuaj hauv lub hlwb. Kev siv lub sijhawm ntev ntawm cov tshuaj insulin, kev kuaj mob ntawm lub cev cov ntshav thiab cov ntshav rau cov ntsiab lus ntawm cov suab thaj hauv nws yuav tsum muaj. Xws li kev tshawb fawb los qhia meej txog lub sijhawm siab tshaj plaws rau kev noj tshuaj kom ua tiav qhov txiaj ntsig siab kawg.

Txhawm rau tswj hwm cov tshuaj, cov tshuaj insulin tshwj xeeb los yog cov xaum xaum tshwj xeeb feem ntau siv.