Glucocorticosteroids thiab nws cov txiaj ntsig rau cov piam thaj hauv qib

Koj tuaj yeem paub cov lus txaus ntshai: ntshav qab zib tuaj yeem pib vim yog siv tshuaj! Yog nws tau. Tsis txhob txhawj xeeb, peb tsis tham txog kev mob ntshav qab zib ib txwm muaj - T1DM thiab T2DM. Qee cov tshuaj ua rau nce ntshav qabzib. Niaj hnub no peb yuav tham txog cov tshuaj feem ntau siv los ntawm cov koob no - glucocorticoids.

Glucocorticoids (lawv kuj yog glucocorticosteroids) yog cov tshuaj qog ntshav adrenal. Peb lub cev xav tau glucocorticoids txhawm rau tiv thaiv kev ntxhov siab - tsis yog tsuas yog kev xav lossis ua haujlwm poob siab xwb, tabsis tseem muaj kev ntxhov siab thaum ua haujlwm, raug mob, mob hnyav, thiab lwm yam. Tsis tas li, glucocorticoids tuaj yeem:

Txo kev o,
Ntaus kev ua xua
Txhawb nqa cov haujlwm ntawm lub cev tiv thaiv kab mob.

Vim tias cov khoom no, glucocorticoids yog siv dav, thiab qee zaum tsis tuaj yeem ua haujlwm:

Nrog adrenal tsis txaus - ua qes ntawm lawv tus kheej cov tshuaj hormones,
Hauv cov kab mob mob mus ntev (piv txwv li, mob rheumatoid mob caj dab thiab mob hlwb lupus erythematosus),
Kev ua xua nrog kev ua xua (piv txwv, nrog mob ntsws asthma lossis Quincke's edema),
Thaum hloov khoom nruab nrog cev thiab cov ntaub so ntswg,
Thaum poob siab.

Ua raws li cov kabmob, glucocorticoids yog siv tshuaj pleev (tshuaj pleev qhov muag, tshuaj txau, tshuaj pleev) lossis txheej txheem (cov ntsiav tshuaj, kev daws teebmeem ntawm kev txhaj tshuaj), hauv chav kawm luv lossis txuas ntxiv. Glucocorticoids yog cov tshuaj zoo heev, tab sis nrog kev siv system muaj lawv muaj ntau ntawm cov teebmeem tsis xav tau. Cia peb nyob ntawm qhov tseem ceeb tshaj plaws rau peb - kev nce ntshav qab zib.

Peb twb tau pom tawm glucocorticoids yog kev ntxhov siab cov tshuaj hormones. Kev mob ntshav qab zib tsawg, raws li koj paub, kuj yog ib qho kev ntxhov siab rau lub cev, thiab glucocorticodes nres hypoglycemia thiab nce ntshav qab zib. Qhov no yog ib qho tseem ceeb uas yuav tsum ua uas txhua tus ua haujlwm. Thaum kho nrog glucocorticoids, qib ntawm cov tshuaj hormones ntau dua qhov txwv uas yog lub ntuj tsim rau lub cev, thiab theem ntawm cov piam thaj nce siab yuav luag 50% ntawm cov neeg mob. Tib lub sijhawm, cov ntaub so ntswg tiv thaiv cov tshuaj insulin ntau ntxiv, uas zoo li cov metabolism hauv cov piam thaj hauv ntshav qab zib hom 2.

Cov kev pheej hmoo hauv qab no rau kev hnov qab cov piam thaj hauv kev kho ntshav ntawm glucocorticoids yog qhov txawv:

Ntau qhov loj ntawm cov tshuaj,
Kev kho mob ncua ntev
Laus lub caij nyoog
Rog thiab rog dhau,
Tsis hnov qab qab zib zam,
Mob ntshav qab zib Gestational yav dhau los
Ntshav qab zib Hom 2 nyob rau hauv cov neeg txheeb ze.

Hauv cov neeg muaj mob ntshav qab zib ua ntej, txawm tias muaj kev kho mob sai sai ntawm cov kab mob glucocorticoid, kev tswj cov piam thaj feem ntau yuav ua mob phem. Tab sis txhob txhawj! Qhov tseem ceeb tshaj plaws yog kho cov tshuaj kho nrog koj tus kws kho mob thiab cov piam thaj yuav rov qab zoo li qub.

Glucocorticoids (nruab nrab-ntev ntev) glucocorticoids (prednisone, methylprednisolone) nce qab zib nyob rau hauv 4-8 teev tom qab noj. Cov tshuaj glucocorticoids ntev ntev (dexamethasone, betamethasone) tuaj yeem tuav cov piam thaj siab kom txog 24 teev. Kev nce ntshav ntxiv hauv lub cev sib xws rau lub koob tshuaj - ntau dua qhov koob tshuaj, muaj suab thaj ntau dua.

Tau kawg, nws yog ib qho tseem ceeb heev rau cov neeg muaj ntshav qab zib thiab muaj kev pheej hmoo rau nws txoj kev txhim kho los tswj cov ntshav qabzib thaum kho nrog glucocorticoids. Yog tias koj tsis muaj ntshav qab zib, nws yuav txaus los ntsuas qhov ntsuas ntshav qab zib 1 zaug hauv ib hnub, nyiam dua ua ntej noj su lossis ua hmo. Yog tias koj twb muaj ntshav qab zib, koj yuav tsum ntsuas ntsuas qab zib tsawg kawg 4 zaug hauv ib hnub (thiab tseem ntau tshaj yog muaj kev kho mob insulin!).

Thaum cov ntshav qab zib muaj tshwm sim thaum noj glucocorticoids, kev kuaj mob tsis txawv ntawm cov ib txwm muaj: 7 mmol / L thiab siab dua ntawm lub plab khoob thiab 11.1 mmol / L thiab siab dua 2 teev tom qab noj mov. Yog tias cov lej ntawd tau tsau, nws yuav tsim nyog yuav pib kho qhov mob hypoglycemic.

Thaum glucocorticoid txoj kev kho tiav, kev mob ntshav qab zib feem ntau ploj lawm. Tab sis yog tias muaj kev pheej hmoo, ua rau cov metabolism hauv cov ntshav qab zib tsis txaus tuaj yeem ua lub siab ntev thiab mus rau hom ntshav qab zib hom 2.

Pharmacological cov yam ntxwv, daim ntawv, taw qhia, cov kev txwv

Dexamethasone yog glucocorticosteroid hormone, yog li ntawd nws muaj lub siab tiv thaiv, tiv thaiv kab mob, tiv thaiv kev ua xua, txhim kho qhov rhiab heev ntawm β-adrenergic receptors rau catecholamines. Dexamethasone ua rau muaj qhov rov tshwm sim hauv cov txheej txheem uas pab txhawb cov synthesis protein molecules. Raws li tshuaj ntawm cov yeeb tshuaj, kev tsim cov ntshav plasma protein thiab albumin nyob rau hauv daim siab thiab lub raum cov ntaub so ntswg. Txhim kho qhov tsim ntawm lipid molecular qauv. Lub cev rog yog tsim los ntawm lub ntsej muag, lub xub pwg plhaw, thiab lub plab. Qib ntawm cov roj (cholesterol) hauv cov hlab ntshav tau nce siab.

Qhov kev txiav txim ntawm Dexamethasone rau cov ntshav qab zib muaj raws li nram no: txhim kho kev nqus ntawm cov suab thaj hauv kev zom, ua rau muaj kev nce siab ntxiv ntawm cov piam thaj hauv cov ntshav, ntxiv kev tsim cov nplooj siab enzymes, vim qhov kev hloov kho ntawm glucogenesis, ua rau kev loj hlob ntawm hyperglycemia (nce qab zib).

Dexamethasone txo cov calcium nyob rau hauv cov pob txha nqaij, txo qis lub cev thiab kua dej hauv lub cev. Cov tshuaj ua rau txo qis mob los ntawm kev txo cov synthesis ntawm cytokines, leukotrienes, macrophages thiab lwm cov tshuaj tiv thaiv kab mob. Nws stabilizes permeability ntawm cell week, raws li zoo li intracellular qauv. Nws inhibits kev ua haujlwm ntawm T thiab B hlwb ntawm lub cev tiv thaiv kab mob. Txo kev sib txuas ntawm cov tshuaj tiv thaiv tshwj xeeb. Txhawb nqa qhov tso tawm ntawm mast hlwb uas coj los ua ke hyaluronic acid, histamine.

Txo qhov o ntawm cov leeg ntawm lub ntsws, txo qhov tsim muaj cov hnoos qeev hauv qhov chaw ntawm lub ntsws thiab bronchioles, me ntsis dilutes hnoos qeev. Nws inhibits qhov tso pa tawm ntawm adrenoglucocorticosteroid hormone. Cov metabolism ntawm cov tshuaj kis hauv daim siab mob. Nws tso tawm hauv qhov mob txeeb zig. Dexamethasone muaj peev xwm nce ntshav siab.

Cov tshuaj yog tsim nyob rau hauv txhaj tshuaj thiab daim ntawv ntsiav tshuaj. Ampoules nrog tov tov tsim ntim ntawm 1 thiab 2 ml. 1 ampoule (2 ml) muaj 8 mg ntawm Dexamethasone, ampoule (1 ml) - 4 mg ntawm cov tshuaj. 1 ntsiav tshuaj muaj 0.0005 g ntawm cov tshuaj yeeb dej caw.

Cov Kev Txwv

cov kab ke hauv lub cev (lupus erythematosus, mob rheumatic, dermatomyositis, scleroderma),
kab mob thaum yau thiab neeg laus sib koom tes,
kev ua xua
daim tawv nqaij mob
cerebral edema (nqaij hlav, puas, ua kom phais mob, tom qab kho hluav taws xob),
pathology ntawm lub qhov muag ntawm kev tsis haum, mob tiv thaiv mob,
cov qog adrenal tsis zoo, adrenal hyperplasia,
autoimmune lub raum pathology (glomerulonephritis, nephrotic syndrome),
lub qog ua ntshav
cov kab mob ntawm cov ntshav hematopoietic (ntshav liab, ntshav ntswg),
pulmonary pathologies (mob ntsws asthma, sarcoidosis, fibrosis, alveolitis),
kev puas tsuaj rau mob ntsws, hlwb,
kev mob qog ua rau lub ntsws
lub plab zom mov pathology (Crohn's disease, enteritis, ulcerative colitis),
ntau yam sclerosis
mob rau daim siab (tseem autoimmune),
nce calcium ntawm cov hlab ntsha hauv oncopathologies,
kev tiv thaiv ntawm kev txhim kho ntawm cov kev hloov tsis lees (nrog rau lwm cov tshuaj),
myeloma
thaum nqa tawm kev ntsuam xyuas ntawm kev kuaj pom qhov txawv ntawm adrenal oncology,
poob siab mob.

kis kab mob
ntshav los ntshav tshuaj hauv keeb kwm,
hypersensitivity rau cov tshuaj,
pob txha lov
deforming arthrosis,
lub sij hawm tom qab txhaj tshuaj tiv thaiv,
post-infarction mob
hyperlipidemia,
mob ntshav qab zib mellitus
txha txha caj qaum
mob siab thiab mob raum tsis ua hauj lwm.

Dexamethasone muaj ntau qhov kev mob tshwm sim uas yuav tsum xav txog thaum kho cov neeg mob.

Undesirable zoo ntawm cov tshuaj:

Itsenko-Cushing's syndrome,
arrhythmias
dyspepsia
ntshav siab
delirium, euphoria,
kev kub siab hauv cov fundus,
pob txha loj hlob qeeb qeeb nyob rau hauv cov menyuam yaus,
kev ua xua thiab lwm tus.

Cas yuav dexamethasone cuam tshuam rau cov metabolism hauv carbohydrate

Puas yog Dexamethasone Ua Rau Cov Ntshav Qab Zib? Cov tshuaj muaj peev xwm txhim kho qhov nqus ntawm cov suab thaj los ntawm cov hnyuv phab ntsa. Thaum cuam tshuam nrog cov tshuaj, qhov haujlwm ntawm enzyme glucose-6-phosphate tau txais. Qhov enzyme no pab txhawm rau txhawm rau kev nkag mus ntawm cov piam thaj los ntawm nplooj siab mus rau hauv cov ntshav. Tom qab qhov no, qhov zais ntshis ntawm daim siab enzymes yog kho kom zoo. Cov txheej txheem no ua rau pib ntawm gluconeogenesis nyob rau hauv daim siab mob ntshav, uas yog qhov laj thawj rau qhov nce ntawm cov piam thaj.

Thaum lub sijhawm siv Dexamethasone hauv tus neeg mob ntshav qab zib, cov ntshav qab zib cov ntshav yuav nce sai heevCov. Cov piam thaj ntau tuaj yeem ua rau hyperglycemic coma. Nws heev lub neej hem. Hauv qhov no, tus neeg mob xav tau kev kho mob.

Yog tias tus neeg mob tau mob ntshav qab zib ua ke thiab lwm yam kab mob uas yuav tsum muaj kev kho mob nrog glucocorticosteroid hormones (GCS), ces kev kho yog raug txiav txim hauv luv luv kev kawm. Txoj kev kho yuav tsum yog ua tiav los ntawm kev saib xyuas ntawm tus kws kho mob, nrog rau kev tswj ntshav kuaj ntshav qab zib. Nrog kev nce siab hauv cov ntshav qab zib, kho yuav tsum tau tso tseg.

Xaus

Lawv sim kom tsis txhob siv dexamethasone rau cov ntshav qab zib, vim nws zoo ntxiv cov piam thaj hauv cov hlab ntshav. Txuas ntxiv siv corticosteroids tuaj yeem ua rau mob ntshav qab zib steroid. Nws raug txais los siv cov tshuaj rau ntshav qab zib, tab sis tsuas yog lwm txoj kev kho tsis pab. Nws yog qhov zoo dua los hloov Dexamethasone nrog lwm txoj hauv kev kho kom zoo. Lub xub ntiag ntawm cov ntshav qab zib mellitus (cov ntshav qab zib hauv ntshav siab) ua rau muaj kev kho mob ntau yam mob, qhov nyuaj ntawm kev kho mob ntawm cov uas suav nrog Dexamethasone. Yog li, hnub no, cov kws kho mob pom zoo ua lub neej zoo los txo qis cov ntshav qab zib.

Vidal: https://www.vidal.ru/drugs/dexamethasone__36873
Hawm Vaj: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGu>

Pom yuam kev lawm? Xaiv nws thiab nias Ctrl + Enter

Cov tshuaj tiv thaiv kom zoo rau kev siv tshuaj

Nws yog qhov tseeb tias, zoo ib yam li lwm yam kev kho mob, cov tshuaj no kuj muaj qee qhov contraindications. Piv txwv li, nws tsis tuaj yeem siv yog tias muaj qee qhov muaj peev xwm siab rau qhov kev sib xyaw uas ua rau nws cov ntawv.

Ib qho laj thawj rau kev tshem tawm txoj kev kho mob nrog cov tshuaj no tuaj yeem ua lwm hom kev kis mob. Qhov no feem ntau tshwm sim thaum tsis muaj cov tshuaj tua kab mob zoo siv thaum lub sijhawm ua haujlwm ntawm tus kabmob. Txwv tsis pub siv cov tshuaj no ib zaug thiab txhaj tshuaj tiv thaiv tus kheej tuag tseem raug txwv.

Txawm hais tias yog peb tham txog txhua qhov ua tau contraindications, qhov tseem ceeb tshaj plaws yog meej hypersensitivity. Hauv txhua lwm yam mob, kev siv tshuaj yog qhov muaj kev nyab xeeb heev. Thiab txiav txim los ntawm qhov ntsuas ua haujlwm, cov tshuaj no tau sau tseg yuav luag tas li, txawm hais tias ua tau contraindications.

Raws li rau lub sijhawm txhaj tshuaj tiv thaiv, nws zoo dua rau qhov tsis koom nrog kev kho mob yog tias tus neeg mob tau txhaj tshuaj nrog BCG, uas yog tias yim lub lis piam tsis dhau los ntawm hnub no.

Nrog kev ceev faj, koj yuav tsum siv cov tshuaj thaum tus neeg mob tau mob HIV los yog AIDS.

Daim ntawv teev cov contraindications tseem suav nrog ntshav qab zib. Dua li lwm yam teeb meem nrog cov tib neeg endocrine system.

Daim ntawv teev tag nrho cov kev tuaj yeem pom muaj kev yooj yim mus nrhiav hauv cov lus qhia rau cov tshuaj.

Kuv xav xav nyob hauv ntau dua kev qhia txog kev kho mob ntawm ntau yam kab mob nrog cov tshuaj tsis-steroidal anti-inflammatory tshuaj hauv ntshav qab zib. Nws twb tau hais saum toj no tias cov cheebtsam uas ua rau cov tshuaj yuav pab ua kom cov ntshav qabzib nce siab.

Qhov no yog vim qhov tseeb tias insulin synthesis yog suppressed hauv lub cev tom qab noj tshuaj. Yog li, nws tsis pom zoo siv los ntawm tus neeg mob uas mob ntshav qab zib hom 2.

Tab sis thaum nws los txog rau cov neeg mob uas muaj thawj hom mob ntshav qab zib, kev kho mob nrog cov tshuaj no tuaj yeem ua raws kev tswj hwm nruj ntawm kws kho mob.

Cov lus qhia tshwj xeeb rau kev siv

Thawj qhov uas yuav tsum nco ntsoov yog qhov tseeb hais tias kev kho mob ntawm cov tshuaj no ua rau muaj ntshav nce ntxiv hauv cov ntshav. Yog li, cov neeg mob ntshav qab zib yuav tsum siv cov tshuaj nrog kev ceev faj heev. Qhov kev kho mob yog ua tiav los ntawm kev saib xyuas kev kho mob nruj nrog kev ntsuas ntsuas cov ntshav qab zib kom tsis tu ncua, yog tias tsim nyog, kev nce qib ntawm ib qho tshuaj txo qab zib.

Raws li tau hais los saum no, Dexamethasone tsis pom zoo siv rau hauv qhov muaj qee qhov ua rau muaj kev cuam tshuam rau ntau yam kabmob. Qhov no feem ntau tshwm sim rau cov xwm txheej uas tus neeg mob muaj tshuaj tiv thaiv tsawg.

Piv txwv li, qhov no tuaj yeem tshwm sim thaum kev txhim kho ntawm kev mob hnyav xws li kev mob ntsws lossis AIDS. Hauv ob qho xwm txheej, nws yog ib qho tseem ceeb uas yuav tsum siv cov tshuaj tiv thaiv kab mob ua ke nrog cov tshuaj no, nrog rau cov uas muaj cov nyhuv antimicrobial.

Nws yuav tsum raug sau tseg tias tom qab kev kho mob ntev nrog rau cov tshuaj saum toj no, namely rau peb lub lis piam lossis ntau dua, nws yog ib qho tseem ceeb kom thim cov tshuaj maj mam hloov. Txwv tsis pub, muaj qhov teeb meem loj uas qhov tshwm sim adrenal txuas ntxiv tsis tuaj yeem tsim kho.

Yog tias menyuam yaus raug kho, nws yog ib qho tseem ceeb kom soj ntsuam qhov kev hloov pauv ntawm lawv lub cev kev loj hlob. Tshwj xeeb tshaj yog thaum nws los txog kev kho mob ntev ntev, rau ob peb lub hlis lossis txawm xyoo.

Nws yog ib qho tseem ceeb kom hloov kho koj txoj kev noj haus thaum kho. Nws yog qhov zoo dua los xaiv cov khoom noj uas muaj cov pa roj ntau ntau. Thiab, ntawm chav kawm, feem ntau, cov zaub mov yuav tsum noj qab haus huv thiab nplua nuj nyob hauv cov vitamins.

Nws yog ib qho tseem ceeb uas yuav tau saib xyuas tus neeg mob lub cev kev noj qab haus huv txawm tias tom qab tsis mus kho. Qhov chaw nyob hauv ib xyoos tom qab kev noj tshuaj tiav, yuav tsum muaj kev tshuaj xyuas tas li kom tshem tawm qhov muaj peev xwm rov huam.

Raws li rau kev kho mob nrog cov tshuaj thaum cev xeeb tub, nws yuav tsum nrog ceev faj nyob rau hauv kom ze rau txoj kev kho no. Tsuas yog tias muaj kev cia siab tshwm sim rau cov niam uas tseem muaj sia nyob ntau dua qhov muaj feem ua rau muaj menyuam hauv plab, nws yuav tsum pib kho.

Hauv thawj peb lub hlis, nws yog qhov zoo dua rau qhov txwv tsis pub noj cov tshuaj no.

Cov lus qhia rau kev siv tshuaj

Cov lus qhia rau kev siv tshuaj muaj ntau cov lus qhia txog cov kev kuaj mob tshwj xeeb uas qhov tshuaj no yuav tsum tau siv, nrog rau kev noj cov ncauj lus kom ntxaws thiab cov kev mob tshwm sim uas cov tshuaj yuav muaj.

Yog tias peb tham txog xyov cov tsos mob twg cov tshuaj no tshem tawm, nrog rau cov kab mob dab tsi nws yuav tsum tau siv, nws pom tseeb tias cov spectrum ntawm kev ua ntawm cov tshuaj yog dav heev.

Kev kho mob nrog tus neeg sawv cev no yuav tsum tau nqa tawm yog tias yuav tsum tau ua rau tshem tawm qhov mob siab uas muaj nyob hauv tus neeg mob lub cev, zoo li thaum nws tsim nyog los tiv thaiv kev txhim kho ntawm edema, hyperemia thiab phagocytosis.

Yog lawm, nws yuav tsum raug sau tseg tias cov tshuaj no yog cov tshuaj tiv thaiv ntau dua, yog li nws feem ntau siv los daws cov tsos mob, thiab tsis yog tshem tawm qhov ua rau muaj mob sai sai.

Yog tias koj siv cov tshuaj thaum cov txheej txheem ntau yam tshuaj, koj yuav muaj peev xwm txo qhov feem ntau ntawm cov ntaub so ntswg los teb rau qhov kev mob tshwm sim no. Nws yog tiv thaiv los ntawm kev tsub zuj zuj ntawm leukocytes, thiab tseem muaj ib tug xov tooj ntawm lwm yam kev ua uas ncua lub txheej txheem tshuaj tiv thaiv tag nrho.

Kev qhia rau kev siv tshuaj

Txawm hais tias qhov tseeb tias tshuaj rov ua rau cov qog adrenal, yog li txhim kho kev tsim cov tshuaj hormones tsim nyog hauv lub cev, nws tsis tshua muaj siv hauv ntshav qab zib. Qhov no yog vim qhov tseeb tias cov tshuaj no pab txhawb cov ntshav qab zib kom ntau. Yog tias, txawm li cas los xij, kev txiav txim siab tau txiav txim siab los siv cov tshuaj no rau kev kho mob ntawm cov neeg mob ntshav qab zib hom 1, tom qab ntawd nws tsim nyog nce cov tshuaj ntawm cov ntshav qab zib kom tsawg thiab saib xyuas cov ntshav qabzib hauv tus neeg mob cov ntshav.

Cov cim tseem ceeb rau kev siv cov tshuaj yog:

adrenal tsis txaus,
adrenal tsis txaus (mob siab),
adrenal tsis txaus, uas tshwm sim los ntawm kev tshem tawm sai ntawm qee pawg tshuaj,
thawj lossis theem siab tsis ua haujlwm ntawm cov khoom no.

Ib qho ntxiv, nws kuj tuaj yeem ua ntawv tshuaj yog tias tus neeg mob tau mob qog nqaij hlav ntshav ntawm lub ntsws ntawm qhov mob no los yog ua rau cov thyroiditis. Cov tshuaj muaj txiaj ntsig zoo rau kev hlawv ntawm ib daim ntawv twg, uas yog thaum muaj lwm yam tshuaj vasoconstrictor tsis ua hauj lwm zoo. Kev kuaj mob tsis yog kev zam, nws yog txuam nrog kev mob hlwb, piv txwv li, ntau yam puas hlwb raug mob, mob rau daim npluag paj hlwb, txha caj qaum thiab lwm yam mob sib xws.

Hauv qee kis xwm txheej, cov tshuaj no tuaj yeem siv rau bronchospasm loj uas tshwm sim thaum lub caij txhim kho kev mob ntsws asthma. Nws tau sau tseg tias nws tseem ua tau zoo nyob rau hauv cov ntaub ntawv ntawm ntau qhov kev txhaum ntawm kev tsis haum tshuaj, feem ntau, ntawm chav kawm, nyob rau hauv cov ntaub ntawv mob hnyav no, vim tias nws tuaj yeem suav ua ib qho ntawm cov tshuaj uas tuaj yeem siv thaum muaj kev tsis haum tshuaj tiv thaiv mob ntshav qab zib mellitus. Cov mob Rheumatic tseem tuaj yeem ua vim li cas siv.

Nyob rau hauv dav dav, daim ntawv no yog qhov dav heev. Tab sis, tau kawg, koj tuaj yeem siv cov tshuaj tsuas yog tom qab ua tiav kev soj ntsuam ntawm tus neeg mob. Koj tsis tuaj yeem pib kho mob ntawm koj tus kheej, tus kws kho mob yuav tsum sau ntawv rau koj cov tshuaj.

Kev txheeb xyuas ntawm kev siv cov tshuaj

Muaj ntau qhov kev txheeb xyuas nyob hauv Is Taws Nem ua rau nws nkag siab hauv qee qhov xwm txheej twg nws yog qhov zoo tshaj plaws kom tsis txhob siv cov tshuaj no, thiab nyob rau hauv uas nws zoo tshaj.

Piv txwv li, qee tus neeg mob thov tias tom qab siv sijhawm ntev los ntawm cov tshuaj, lawv pom cov kev mob tshwm sim xws li coj khaub ncaws tsis coj khaub ncaws thiab kev loj hlob ntawm cov adrenal tsis txaus. Kev saib xyuas tshwj xeeb yuav tsum tau saib xyuas thaum kho cov neeg mob ntshav qab zib. Txij li thaum, cov Cheebtsam ntawm cov tshuaj txo nws zoo nyob qabzib. Yog tias koj siv cov tshuaj rau lub sijhawm ntev heev, tom qab ntawd kev tiv thaiv kev loj hlob tuaj yeem pom hauv cov menyuam yaus.

Kev phiv los ntawm kev ua haujlwm ntawm cov hlab plawv cov ntshav kuj tseem tuaj yeem.

Kev tshuaj xyuas ntawm cov neeg mob uas tau siv cov tshuaj no thaum kho lawv cov kab mob qhia tau hais tias nws muaj txiaj ntsig zoo rau ntau yam kev mob caj dab, zoo li thaum tau muab tshuaj rau qhov ncauj rau cov pob qij txha tsis ruaj khov.

Muaj tseeb, tib txoj kev tshuaj xyuas tseem tuaj yeem qhia tau tias cov tshuaj tuaj yeem ua rau tus neeg mob noj qab haus huv yog tias nws muaj ntau yam kab mob ntawm txoj hnyuv, nrog rau kev kis mob fungal, mob pob txuv, qhua pias lossis mob qhua pias.

Yog lawm, zoo li lwm yam, koj tuaj yeem nrhiav pom ob qho tib si ntawm qhov zoo los ntawm qhov kev coj ntawm no. Tab sis, txawm hais tias muaj ntau cov kev mob tshwm sim, cov hauj lwm zoo ntawm cov tshuaj no yog siab dua txhua qhov tsis zoo tshwm sim. Qhov loj tshaj plaws yog los coj kev kho mob nyob rau hauv kev saib xyuas nruj ntawm tus kws kho mob.

Tus nqi ntawm cov tshuaj thiab nws analogues

Yog tias peb tham txog cov nqi ntawm cov tshuaj no, ces nws pheej yig heev. Tau kawg, nws tag nrho yog nyob ntawm qhov chaw tsim khoom tshwj xeeb thiab daim ntawv tso tawm, tab sis feem ntau cov nqi rau kev ntim khoom tsis dhau 100 rubles.

Muaj tseeb, muaj kev zam, piv txwv li, Dexamethasone-Vial los ntawm lub tuam txhab CCSPiOui nqi 254 rubles. Nyob rau hauv nqe tus nqi no tseem muaj tshuaj uas muab los ntawm cov chaw tsim khoom los ntawm Is Nrias teb thiab Slovenia, nyob rau hauv rooj plaub no tus nqi nce mus txog 215 rubles, tab sis cov pob yuav muaj 25 ampoules, txhua tus muaj 1 ml ntawm tshuaj kho mob muaj qhov muaj zog ntawm 4 mg.

Feem ntau, nws yuav tsum raug sau tseg tias txhua yam tshuaj los ntawm cov tuam txhab sib txawv, uas muag hauv ntim uas muaj 25 ampoules ntawm ib ml txhua, ntau ntawm 212 txog 225 rubles.

Yog tias peb tham txog cov tshuaj, uas tau muag hauv cov qauv ntawm cov kua muag, ces nws tus nqi feem ntau tsis tshaj 40 rubles. Tab sis ntawm no peb tab tom tham txog txoj kev daws teeb meem nrog qhov siab ntawm 0.1%. Yog lawm, nws tus nqi yuav siab dua, nws txhua tus raws qhov ntim ntawm lub peev xwm.

Nws yuav tsum raug sau tseg tias ua ntej pib siv cov tshuaj, nws yog qhov zoo dua rau sab laj nrog koj tus kws kho mob ua ntej thiab qhia meej hauv daim ntawv tso tawm cov tshuaj uas xav tau thiab qhov nws xav tau, thiab tsuas yog tom qab ntawv thiaj li tau cov tshuaj. Daim vis dis aus hauv tsab xov xwm no yuav tham txog cov tshuaj.

Cov ntaub ntawv dav dav

Kev npaj tshuaj muaj nyob rau cov pab pawg ntawm glucocorticosteroids uas muaj kev tiv thaiv kev ua xua, tiv thaiv kev tiv thaiv, tiv thaiv kab mob thiab muaj tshuaj tiv thaiv antitoxic.

Qab zib yog txo tam sim ntawd! Mob ntshav qab zib ntev mus ntev tuaj yeem ua rau tag nrho cov kab mob, xws li teeb meem tsis pom kev, tawv nqaij thiab plaub hau, mob rau sab hauv, mob caj pas thiab mob qog nqaij hlav! Cov neeg qhia kev iab kev xav ua kom lawv cov suab thaj theem. nyeem rau.

Dexamethasone tiv thaiv lossis txo cov tsos mob ntawm kev fab tshuaj thiab thim cov kev ua kom poob siab. Nrog kev pab los ntawm cov cuab yeej siv kho mob tau piav, cov protein nyob hauv ntshav tau txo qis thiab nws cov catabolism hauv cov leeg nqaij tau kho kom zoo dua. "Dexamethasone" pab txhawm rau txhawm rau nkag mus ntawm cov ntshav qabzib los ntawm lub siab mus rau hauv cov ntshav, khaws cov sodium ions thiab dej hauv lub cev, thaum ua kom lub cev tsis txaus ntawm cov poov tshuaj thiab txo qhov nqus ntawm calcium los ntawm cov hnyuv. Dexamethasone muaj peev xwm nce ntshav siab ntxiv, txo qis permeability ntawm cov hlab ntsha phab ntsa thiab ua tau ntawm kev ua haujlwm caws pliav.

Cov ntsiab lus siab tshaj plaws ntawm "Dexmetasone" hauv cov ntshav tau sau tseg 5 feeb tom qab kev tswj hwm iv thiab 60 feeb tom qab kev tswj hwm. Cov tshuaj yog metabolized tsuas yog nyob rau hauv daim siab thiab tsuas yog ib feem me me ntawm nws - hauv lub raum thiab lwm yam hauv nruab nrog cev. Lub hauv nruab nrog hauv cov khoom lag luam kws tshuaj "Dexamethasone" tau dhau los ntawm kev ua haujlwm ntawm lub raum thaum nruab hnub.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Ib cov tshuaj yog tsim hauv cov qauv ntawm cov kev daws teeb meem rau kev tswj hwm qhov ncauj. Nws muaj nyob rau hauv nws cov muaj pes tsawg leeg muaj kev ua yeeb tshuaj - dexamethasone sodium phosphate thiab cov ntu ntu:

Cov kev ua tau zoo ntawm cov tshuaj "Dexamethasone" tau ua pov thawj hauv kev kho cov kab mob hauv qab no:

Cov tshuaj yog qhia rau kev ua haujlwm tsis zoo ua ntej ntawm adrenal cortex.

cerebral edema,
tsis txaus nyob rau hauv lub cev ntawm vitamin B12,
mob rwj ntawm lub ntsws ua pa,
ib qho kab mob ntawm cov kab mob sib txuas ntawm cov roj ntsha ntawm lub cev autoimmune, ua hauv ib daim ntawv ntev,
txo cov ntshav platelet thiab ntshav dawb hauv lub cev,
cov tsis muaj peev xwm thiab subacute cov thyroid hormones txaus,
ib qho kab mob los ntawm kev puas tsuaj rau cov tib neeg cov kabmob ntshav liab,
mob hlwb pob txha tsis ua haujlwm,
exacerbation ntawm erythroderma,
mob ntawm daim tawv nqaij,
kev mob plab yug los ntawm adrenal cortex.

Rov qab rau cov lus txheej txheem

Ntshav qab zib li cas cuam tshuam rau lub cev?

Rau cov neeg mob uas tau kuaj mob ntshav qab zib mellitus thaum kuaj mob, tshuaj kws kho mob Dexamethasone yog contraindicated.

Qhov txwv tsis pub siv yog vim muaj peev xwm ntawm kev siv tshuaj los cuam tshuam rau kev ua kom cov piam thaj hauv cov neeg mob cov ntshav. Cov tshuaj tseem ceeb ntawm cov tshuaj tsub kom cov ntsiab lus qabzib nyob hauv ntshav, uas yog qhov tsis txaus siab nyob rau hauv ntshav qab zib. Yog hais tias kev siv Dexamethasone rau cov neeg mob ntshav qab zib yog yam mob tsis tau, ces kev kho yuav tsum tau ua nrog ceev faj, nyob rau hauv kev saib xyuas nruj ntawm tus kws kho mob thiab raug ntsuas ntsuas ntsuas cov ntshav qab zib. Nws yuav tsum tau yug los rau hauv lub siab tias thaum lub sijhawm kho nrog glucocorticosteroid yeeb tshuaj, kev nce ntxiv ntawm cov tshuaj uas tswj cov piam thaj hauv ntshav qab zib kuj yuav tsum tau.

Cov kev thaiv tsis zoo thiab cov tshwm sim

Nws tsis pom zoo siv "Dexamethasone" hauv cov neeg mob uas muaj cov kabmob thiab cov mob hauv qab no:

mob ntshav qab zib mellitus
kab mob ua kom mob pob txha
hypercorticism cov tsos mob
advanced daim ntawv ntawm cov kab mob, cov kab mob khaub thuas thiab fungal,
lactation lub sijhawm thiab cev xeeb tub,
Tus kab mob Werlhof
hypersensitivity rau lub Cheebtsam cov tshuaj.

Nrog rau kev xyuam xim nce ntxiv, koj yuav tsum siv "Dexamethasone" rau kev mob plab, mob plab, mob cab ntawm ntau yam. Cov tshuaj tuaj yeem ua rau cov neeg mob uas tsis muaj kev tiv thaiv kab mob, CCC cov kab mob, endocrine pathologies thiab kev ua haujlwm tsis zoo ntawm lub raum thiab mob siab. Thaum tseem yau, kev noj tshuaj yog tso cai tsuas yog qhia los ntawm kws kho mob tom qab coj mus rau hauv tag nrho cov kev pheej hmoo txaus ntshai.

Dexamethasone tuaj yeem ua rau cov kev tsis zoo hauv qab no:

Ib tug phiv yuav tshwm sim nyob rau hauv daim ntawv ntawm hiccups.

txo qis nyob rau hauv cov concentration ntawm calcium, potassium, sodium hauv cov ntshav,
nce hws
mob ntshav qab zib steroid
rog dhau
kiv tob hau, mob taub hau,
pheej mob lwm yam
lub siab ua ntxhov,
gagging thiab xeev siab,
o ntawm tus txiav, hlab pas,
cov roj muaj zog ntxiv,
nquag ntsos
ntau dhau ntawm cov calcium,
depressive lub xeev thiab ntxhov siab vim,
kev fab tshuaj tsis haum.

Rov qab rau cov lus txheej txheem

Noj ntau dhau ntawm "Dexamethasone" hauv ntshav qab zib

Thaum siv "Dexamethasone" nyob rau hauv cov koob tshuaj siab, muaj kev pheej hmoo ntawm kev mob nyhav rau lub cev nrog nws cov khoom siv nquag. Yog hais tias noj ntau dhau, cov neeg mob tuaj yeem soj ntsuam qhov nce ntawm cov tsos mob ntawm cov tsos mob tshwm sim. Cov tshuaj tsis muaj cov tshuaj tshwj xeeb, yog li ntawd, kev txhawb nqa thiab kev mob tshwm sim yog nqa tawm.

Cov zaub mov dab tsi ua rau cov ntshav qab zib

Txog kev kho mob pob qij txha, peb cov neeg nyeem tau siv DiabeNot siv tau zoo. Pom qhov nrov ntawm cov khoom no, peb tau txiav txim siab muab nws rau koj kom txaus siab.

Ntau cov zaub mov muaj cov carbohydrates, uas, thaum noj, ua rau cov ntshav qab zib ntau ntau. Qhov ntsuas uas ntsuas cov kev thauj cov zaub mov kom rog yog hu ua glycemic index (GI). Hauv cov ntshiab si, nws yog sib npaug nrog 100 units, thiab tag nrho lwm cov khoom tuaj yeem muaj GI los ntawm 0 txog 100. Qhov ntsuas no nrog tus nqi ntawm 0 txog 39 yog suav tias yog qis, txij li 40 txog 69 - nruab nrab, thiab siab dua 70 - siab. Cov khoom noj uas nce ntshav qab zib kom sai yog cov zaub mov uas muaj glycemic siab, txawm hais tias qee cov khoom noj nrog GI nruab nrab kuj ua rau pom cov nyhuv no. Yog vim li cas cov neeg mob ntshav qab zib yuav tsum paub dab tsi cov zaub mov sai ua kom cov ntshav qabzib nce siab thiab sim cais nws tawm ntawm cov zaub mov noj.

Cov nyhuv ntawm cov zaub mov ntawm cov ntshav qab zib

Feem ntau cov zaub mov muaj cov carbohydrates hauv lawv cov muaj pes tsawg leeg, yog li ib txoj kev los sis lwm qhov lawv cuam tshuam rau cov ntshav qab zib. Qee ntawm lawv nce nws kom du thiab maj mam, yog li lawv siv tsis cuam tshuam rau lub xeev ntawm lub txiav. Lwm qhov ua rau cov piam thaj ntau ntxiv, uas yog ib qho txaus ntshai heev rau ib tus neeg noj qab haus huv, thiab tseem haj yam rau tus mob ntshav qab zib. Qhov ntau dua glycemic qhov ntsuas ntawm lub tais diav, sai dua tom qab noj nws yuav ua rau muaj kev nce siab ntxiv hauv cov suab thaj.

Muab cov khoom tsis zoo ntawm cov zaub mov nrog lub siab carbohydrate load, nws raug nquahu kom tsis kam los ntawm lawv kev siv ntau heev txawm tias cov neeg muaj kev noj qab haus huv zoo. Rau cov mob ntshav qab zib, qhov no tsuas yog tsim nyog, tsis hais hom mob. Txawm hais tias muaj insulin txoj kev kho, koj tuaj yeem tsis txhob noj ntau dhau thiab koom nrog cov zaub mov qab zib, cia siab tias yuav tau txhaj tshuaj. Kev tsis ua raws li kev noj haus ua rau muaj kev puas tsuaj rau txoj kev noj qab nyob zoo ntawm tus neeg mob thiab qhov xav kom nce qhov koob tshuaj uas tau txais los ntawm cov txiv neej. Lub hauv paus ntawm cov zaub mov noj yuav tsum yog cov khoom noj kom zoo: zaub, cereals, qee cov txiv hmab txiv ntoo, cov ntses muaj roj tsawg thiab cov nqaij ua kom neeg noj nqaij. Glycemic qhov taw qhia ntawm qee hom zaub mov raug nthuav tawm hauv lub rooj 1.

Cov Lus 1. Glycemic qhov taw qhia ntawm qee cov khoom

Txiv hmab txiv ntoo thiab zaub

Txiv hmab txiv ntoo muaj cov carbohydrates yooj yim thiab txoj kev. Qee tus kuj tseem muaj ntau cov ntxhib ntxoo noj cov zaub mov kom qeeb qeeb uas ua rau cov piam thaj tsis muaj piam thaj thiab yog li tsis ua rau hyperglycemia. Cov txiv hmab txiv ntoo cov txiv ntoo tau tso cai rau cov neeg mob ntshav qab zib, tab sis nyob ntawm cov tshuaj lom neeg muaj pes tsawg leeg thiab cov ntsiab lus hauv lub cev caloric, qhov kev tso cai noj rau cov tsiaj sib txawv yuav txawv. Tseem muaj cov txiv hmab txiv ntoo uas cov neeg mob yuav tsum tau cais tawm ntawm cov zaub mov vim lawv qhov kev ua haujlwm siab carbohydrate:

Cov txiv hmab txiv ntoo qhuav (tshwj xeeb yog cov figs, cov hnub thiab cov apricots uas tau qhuav) yog qhov muaj calorie ntau thiab GI ntau, yog li cov ntshav qab zib muaj qhov tsis xav noj. Qhov no muaj tseeb tshwj xeeb rau cov neeg mob tus mob thib ob ntawm tus kab mob no thiab cov poj niam muaj ntshav qab zib tsis tsaug zog uas raug yuam ua raws li kev noj zaub mov nruj dua.

Yuav luag txhua cov zaub ntsuab yog cov khoom GI qis lossis nruab nrab, yog li lawv yuav tsum yog qhov pib ntawm tus neeg mob cov khoom noj txhua hnub. Txawm li cas los xij, vim tias muaj cov hmoov txhuv nplej siab ntau, nws zoo dua rau cov neeg mob ntshav qab zib kom txwv lawv tus kheej kom noj cov qos yaj ywm (koj tuaj yeem noj nws, tab sis nws zoo dua los ua qhov no tsis pub ntau tshaj 2 zaug hauv ib lub lis piam). Beets thiab pob kws muaj cov suab thaj ntau hauv qhov muaj pes tsawg leeg, yog li lawv kuj yuav tsum tau muab dosed thiab tsis sib xyaw nrog lwm cov khoom muaj carbohydrates.

Cov piam thaj thiab cov khoom uas muaj nws

Qab zib yog cov khoom lag luam No. 1 uas yuav tsum tau muab cais tawm ntawm kev noj haus ntawm cov neeg muaj mob. Nws ua rau kev nce ntshav hauv cov ntshav khov sai thiab ua rau muaj kev loj hlob ntawm cov kabmob hnyav. Cov neeg mob uas, txawm hais tias tus kws kho mob pom zoo, yuav tsum haus dej qab zib thiab cov khoom uas muaj nws, yuav paub sai sai tias nws muaj kev phom sij li cas. Vim tias cov khoom qab zib, cov ntshav qab zib yuav pib tsim kev phom sij mob ntshav qab zib, uas yog:

mob stroke
polyneuropathy (ua txhaum ntawm lub paj hlwb conduction),
retinopathy (mob hlwb),
mob ntshav qab zib mob ko taw
plawv nres
rog dhau.

Yog lawm, lub cev xav tau carbohydrates, tab sis nws zoo dua rau nws tsis yog los ntawm cov zaub mov qab zib, tab sis los ntawm cov zaub muaj txiaj ntsig zoo thiab zaub mov. Refined suab thaj tsis nqa ib qho tseem ceeb rau lub cev, nws tsuas yog txhim kho qhov qab ntawm zaub mov. Cov khoom qab zib li niaj zaus rau cov ntshav qab zib muaj peev xwm thiab yuav tsum tau hloov nrog cov txiv hmab txiv ntoo, txiv ntoo thiab khoom qab zib los ntawm tsev cheese tsawg. Thaum tsis muaj teeb meem ntawm tus kab mob, qee zaum tus neeg mob tau tso cai rau nws haus me ntsis zib ntab.

Dab tsi cov zaub mov nce ntshav qab zib tshwj xeeb tshaj yog ceev dhau ntawm qab zib ntshiab? Cov no suav nrog cov khob cij dawb, khoom qab zib, chocolate, ncuav qab zib, buns, savory pastries ua los ntawm cov zoo tshaj cov hmoov nplej, cov qos yaj ywm, cov khoom noj ceev thiab cov zaub mov yooj yim. Qab zib tuaj yeem "nkaum" txawm nyob hauv cov khoom uas muaj qhov qab heev. Piv txwv, nws yog ntau yam hauv cov kua ntses, ketchups, marinades. Ua ntej xaiv zaub mov, koj yuav tsum ua tib zoo kawm nws qhov muaj pes tsawg leeg, soj ntsuam cov ntsiab lus ntawm cov calories thiab qhov ntau ntawm cov carbohydrates hauv nws, vim qhov no yog qhov cuam tshuam rau cov ntshav qab zib.

Feem ntau cov cereals nyob hauv daim ntawv pom zoo ntawm cov khoom lag luam rau cov neeg mob ntshav qab zib. Lawv muaj qhov ntsuas nruab nrab ntawm glycemic, cov nqi zog txaus thiab cov tshuaj muaj zog nplua nuj. Cov zaub mov uas siv tau muaj xws li pob kws, nplej, nplej uas tsis tau sau ua pob, buckwheat, bulgur. Cov carbohydrates nyuaj nyob rau hauv lawv cov muaj pes tsawg leeg tau tawg lawm maj, yog li ntawd, tom qab lawv siv, theem ntawm cov piam thaj hauv cov ntshav txhaws maj mam nce mus.

Ntawm cov cereals uas cuam tshuam loj heev rau lub cev ntawm cov ntshav qab zib, ib qho tuaj yeem paub cov semolina thiab cov txhuv dawb. Lauj kaub tais diav npaj los ntawm lawv yog high-calorie, muaj ntau yam sai carbohydrates, thiab nrog nquag siv provoke rog. Lawv xyaum tsis muaj kev tshawb nrhiav kabmob muaj sia, lawv tsuas pw rau hauv lub cev nrog cov "calories" "tsis txaus", thiab qhov no tsis tshua muaj siab rau ntshav qab zib.

Qaub-mis khoom

Cov neeg mob ntshav qab zib tuaj yeem noj cov khoom noj muaj mis uas muaj qhov tsawg kawg nkaus ntawm cov rog. Nws yog qhov zoo dua los tso tag nrho cov mis, txij li nws tau zom rau ntev thiab ua rau tsis xis nyob hauv plab. Txij li cov metabolism hauv lub cev ua rau cov ntshav qab zib mellitus, mis tuaj yeem cuam tshuam tsis zoo rau cov leeg, plab hnyuv thiab lwm yam hauv lub plab zom mov.

Rog yogurts nrog flavours thiab txiv hmab txiv ntoo sau nyob rau hauv muaj pes tsawg leeg tuaj yeem ua rau kev nce hauv qab zib. Tib yam siv rau curd pastes nrog sau. Txawm hais tias fructose ntxiv rau cov piam thaj tsis muaj suab thaj, nws tsis haum rau cov ntshav qab zib. Kev nquag siv cov piam thaj hloov no ua rau cov rog rog vim tias nws cov calories ntau thiab muaj peev xwm ua kom qab los noj mov.

Cov zaub mov no puas yog ib txwm ua rau puas tsuaj?

Hauv qhov xwm txheej ib txwm muaj, cov khoom noj uas muaj qhov ntau ntawm cov nyiaj sai ntawm carbohydrates nyob rau hauv cov lus muaj pes tsawg leeg yuav tsum tsis txhob muaj nyob rau ntawm lub rooj ntshav qab zib. Tab sis muaj cov xwm txheej uas nws tuaj yeem txuag tau kev noj qab haus huv thiab lub neej ntawm tus neeg mob. Nrog rau kev txhim kho hypoglycemia (ib qho kev txawv txav ntawm cov ntshav qab zib), cov khoom lag luam no tuaj yeem muab cov kev pabcuam ua ntej thiab tiv thaiv tus neeg mob los ntawm cov teeb meem loj. Yog hais tias tus mob ntshav qab zib pom tau hais tias cov piam thaj hauv qab zib tau poob rau lub sijhawm, txhawm rau ua kom nws txoj kev mob, raws li txoj cai, nws tau txaus noj lub qhaub cij nrog cov qhob cij dawb, cov khoom noj khoom haus zoo lossis haus ib khob dej qab zib.

Vim tias cov dej qab zib sai sai sai, cov ntsiab lus ntawm cov piam thaj hauv cov ntshav nce siab, thiab tus neeg mob nws xis nyob. Yog tias kev ntsuas tsis tau ua tiav raws sijhawm, ib tus neeg yuav xav tau kev pab cuam kho mob thiab pw hauv tsev kho mob. Kev mob ntshav qab zib yog ib qho txaus ntshai uas txaus ntshai rau lub neej tsis muaj tsawg tshaj li hyperglycemia (ntshav qab zib hauv ntshav siab). Tias yog vim li cas cov kws kho mob pom zoo kom txhua tus neeg mob ib txwm nqa khoom qab zib thiab zaub mov muaj txiaj ntsig nrog cov khoom noj sai kom tau txais kev pabcuam thaum muaj xwm txheej ceev.

Muaj lub tswv yim ntawm cov khoom noj twg tuaj yeem ua rau cov ntshav qabzib nce siab, ib tus neeg tuaj yeem npaj zaub mov noj tau ob peb hnub ua ntej. Nws yog qhov zoo dua uas kev noj haus yog ເດັ່ນ los ntawm cov tais diav uas maj mam tawg thiab nqus hauv lub cev. Lawv nce cov piam thaj hauv cov ntshav hauv cov ntshav ntau dua thiab physiologically, ntxiv mus, tom qab siv lawv, qhov kev xav ntawm kev tshaib plab tsis tshwm sim sai.

Mob ntshav qab zib thiab ceg mob lwm yam. Mob ntshav qab zib - mob ceg - kho mob

Mob ntshav qab zib feem ntau ua rau muaj teeb meem rau ob txhais ceg. Ko taw cov teeb meem thoob plaws lub neej tshwm sim hauv 25-35% ntawm txhua tus neeg mob ntshav qab zib. Thiab cov neeg laus dua, qhov ntau dua qhov yuav tshwm sim ntawm lawv qhov tshwm sim. Kab mob ntawm ob txhais ceg nrog ntshav qab zib coj teeb meem ntau rau cov neeg mob thiab kws kho mob. Ceg mob nrog ntshav qab zib - hmoov tsis zoo, ib qho kev daws teeb meem yooj yim no tseem tsis tau muaj. Yuav tau ua kuv qhov zoo tshaj plaws los kho mob. Ntxiv mus, koj yuav tsum tau kho tsuas yog los ntawm tus kws kho mob tshaj lij, thiab tsis muaj ib qho xwm txheej los ntawm "kev kho mob pej xeem". Hauv tsab xov xwm no, koj yuav kawm yuav ua li cas. Lub hom phiaj ntawm kev kho mob:

Pab txo qhov mob ntawm ob txhais ceg, thiab zoo dua - tshem tawm ntawm lawv,
Txuag lub peev xwm txav "ntawm koj tus kheej."

Yog tias koj tsis them sai sai rau kev tiv thaiv thiab kev kho mob ntawm kev mob ntshav qab zib ntawm ob txhais ceg, tus neeg mob yuav plam tag nrho cov ntiv taw lossis ko taw.

Ntawm ntshav qab zib mellitus, ob txhais ceg raug mob vim tias atherosclerosis tshwm sim muaj ib qho lumen me me hauv cov hlab ntshav nqaim dhau. Cov leeg caj ceg tsis tau txais ntshav txaus, "ua tsis taus pa" thiab yog li xa cov cim qhia mob. Kev ua haujlwm los kho ntshav ntws hauv cov hlab ntsha ntawm qhov qis qis tuaj yeem daws qhov mob thiab txhim kho lub neej muaj ntshav qab zib.

Muaj ob qho xwm txheej tseem ceeb rau cov teeb meem ceg ntshav qab zib:

Mob ntshav qab zib kom ntshav muaj feem cuam tshuam rau cov hlab ntsha leeg, thiab lawv tsum tsis muaj lub siab xav. Qhov no hu ua mob ntshav qab zib neuropathy, thiab vim nws, ob txhais ceg poob lawv qhov kev nkag siab.
Cov hlab ntshav uas pub txhais ceg txhawm vim yog atherosclerosis lossis kev tsim ua kom muaj ntshav txhaws (ntshav txhaws). Ischemia kev tsim tawm - cov pa oxygen tshaib plab ntawm cov ntaub so ntswg. Hauv qhov no, ob txhais ceg feem ntau raug mob.

Atherosclerosis: kev tiv thaiv thiab kev kho mob. Atherosclerosis ntawm cov hlab ntsha ntawm lub plawv, lub paj hlwb, qhov qis qis kawg.
Tiv thaiv lub plawv nres thiab mob stroke. Qhov muaj feem pheej hmoo thiab yuav ua li cas tshem tawm lawv.

Ntshav qab zib mob ko taw

Kev puas tsuaj rau cov hlab ntshav vim cov ntshav tawm suab yog hu ua ntshav qabzib neuropathy. Qhov mob hnyav ntawm ntshav qab zib no ua rau qhov tseeb tias tus neeg mob tsis muaj peev xwm kov nws txhais ceg, mob, siab, kub thiab txias. Tam sim no yog tias nws mob nws sab ceg, nws yuav tsis hnov nws lub siab. Cov neeg mob ntshav qab zib feem ntau hauv qhov xwm txheej no muaj mob rau ntawm txhais ceg thiab txhais taw ntawm tus taw, uas kho tau ntev thiab nyuaj.

Yog tias qhov rhiab ntawm txhais ceg tsis muaj zog, tom qab ntawd cov qhov txhab thiab mob txhab tsis ua rau mob. Txawm hais tias muaj kev puas ntsoog los yog txhuam pob txha ntawm pob txha, ces nws yuav tsis tshua mob. Qhov no yog hu ua tus mob ko taw mob ko taw. Txij li thaum cov neeg mob tsis hnov mob, ntau yam ntawm lawv tub nkeeg heev ua raws li kws kho mob pom zoo. Raws li qhov tshwm sim, cov kab mob ua rau ntau ntxiv hauv cov qhov txhab, thiab vim yog kis tau tus menyuam, txhais ceg feem ntau yuav tsum txiav tu.

Yuav kho li cas rau hom ntshav qab zib 2: txheej txheem ib qib zuj zus
Cov tshuaj ntshav qab zib hom 2: cov ncauj lus kom ntxaws
Siofor thiab Glucofage ntsiav tshuaj
Li cas los kawm kom txaus siab rau kev kawm siv lub cev

Mob peripheral leeg mob ntshav qab zib

Yog tias txoj hlab ntaws ntawm cov leeg ntshav poob, ces cov nqaij ntawm ob txhais ceg pib “tshaib plab” thiab xa cov cim qhia mob. Qhov mob yuav tshwm sim thaum so lossis tsuas yog thaum taug kev. Hauv kev paub, yog tias koj ob txhais ceg mob ntshav qab zib yog qhov zoo. Vim tias qhov mob ntawm txhais ceg txhawb cov ntshav qab zib kom ntsib kws kho mob thiab kho kom zoo li nws lub zog. Hauv tsab xov xwm niaj hnub no, peb yuav xav txog qhov xwm txheej zoo li no.

Cov teeb meem nrog cov hlab ntshav uas pub txhais ceg yog hu ua "kab mob txha caj qaum". Peripheral - txhais tau deb ntawm qhov chaw. Yog tias cov lumen hauv cov hlab ntsha tau nqaim, tom qab ntawd feem ntau muaj ntshav qab zib, sib quas ntus claudication tshwm sim. Qhov no txhais tau hais tias vim yog mob hnyav hauv txhais ceg, tus neeg mob yuav tsum tau taug kev qeeb lossis tsum.

Yog tias tus kab mob peripheral artery muaj nrog tus mob ntshav qab zib neuropathy, tom qab ntawd qhov mob yuav mob me lossis tsis tuaj kiag li. Kev sib xyaw ua ke ntawm vascular txhaws thiab poob ntawm qhov mob rhiab ua rau muaj qhov ua kom ntau ntxiv rau tus mob ntshav qab zib yuav tau txiav ib qho lossis ob sab ceg. Vim tias cov nqaij ntawm ob txhais ceg txuas mus ntxiv vim yog "tshaib plab," txawm hais tias tus neeg mob tsis hnov mob.

Yuav ua li cas kev ntsuam xyuas yog tias koj ob txhais ceg mob ntshav qab zib

Nws yog ib qho tsim nyog yuav tsum ua tib zoo tshuaj xyuas koj ob txhais ceg thiab ko taw txhua hnub, tshwj xeeb tshaj yog thaum muaj hnub nyoog laus. Yog tias cov ntshav ntws los ntawm cov hlab ntsha tau cuam tshuam, tom qab ntawd koj tuaj yeem pom cov cim ntxov ntawm qhov no. Cov tsos mob ntawm tus pib ntawm tus kab mob peripheral leeg:

daim tawv nqaij ntawm ob txhais ceg yuav dhau los ua qhuav
tej zaum nws yuav pib tev tawm, ua ke nrog khaus,
pigmentation lossis depigmentation yuav tshwm sim rau ntawm daim tawv nqaij,
nyob rau hauv cov txiv neej, cov plaub hau ntawm sab ceg qis tig grey thiab ntog tawm,
daim tawv nqaij yuav dhau los ua daj ntseg thiab txias rau tus kov,
los yog hloov ua lwm yam, nws tuaj yeem ua kom sov sov thiab tau cov xim cyanotic.

Tus kws kho mob uas paub dhau los tuaj yeem tshawb xyuas los ntawm kov yam twg mem tes ntawm tus neeg mob muaj nyob rau ntawm cov hlab ntsha uas pub cov nqaij ntawm ob txhais ceg. Qhov no suav hais tias yog qhov yooj yim thiab pheej yig tshaj plaws rau kev kuaj xyuas cov teeb meem hauv lub cev. Nyob rau tib lub sijhawm, kev ntoj ncig ntawm cov leeg nres lossis thim rov qab tsuas yog thaum nws lumen nqaim los ntawm 90% lossis ntau dua. Nws yog lig dhau lawm los mus tiv thaiv kev tshaib plab daim ntaub.

Yog li, lawv siv cov ntaub ntawv tshawb fawb tob dua siv cov khoom siv kho mob niaj hnub no. Qhov piv ntawm systolic ("sab saud" siab) nyob rau hauv cov hlab ntsha ntawm sab ceg qis thiab ceg ntshav txha caj ceg yog suav. Qhov no yog hu ua ankle-brachial index (LPI). Yog tias nws nyob ntawm thaj tsam 0.9-1.2, tom qab ntawd cov ntshav ntws hauv ob txhais ceg yog suav tias yog ib txwm. Ntsuas ntiv tes leeg ntshav yog qhov ntsuas tau.

Lub pob taws-khiab mis taw qhia cov lus qhia tsis raug yog tias cov hlab ntsha cuam tshuam los ntawm Menkeberg's atherosclerosis, uas yog, lawv tau them nrog calcareous "nplai" los ntawm sab hauv. Hauv cov neeg laus cov neeg mob, qhov no tshwm sim ntau zaus. Yog li ntawd, cov hau kev xav tau uas muab cov txiaj ntsig tau raug dua thiab ruaj khov. Qhov no tseem ceeb tshaj plaws thaum kev daws qhov teeb meem ntawm kev phais kom rov qab vascular patency kom ob txhais ceg tsis raug mob.

Hom 1 kho mob ntshav qab zib rau cov neeg laus thiab menyuam
Cov txheej txheem ntawm kev siv tshuaj insulin tsis muaj mob
Mob ntshav qab zib Hom 1 rau menyuam yaus raug kho yam tsis raug siv tshuaj noj kom yog. Xam phaj nrog tsev neeg.
Yuav ua li cas qeeb ntawm kev ua haujlwm ntawm lub raum

Transcutaneous Oximetry

Transcutaneous oximetry yog ib txoj kev tsis muaj mob uas tso cai rau koj soj ntsuam seb cov pa oxygen oxygen zoo npaum li cas. Transcutaneous txhais tau tias “hla ntawm daim tawv nqaij.” Lub ntsuas tshwj xeeb yog siv rau daim tawv nqaij, uas ua rau ntsuas.

Qhov tseeb ntawm qhov kev xeem ntawv nyob ntawm ntau yam:

tus mob ntawm cov mob ntsws ntsws ntawm tus neeg mob,
ntshav hemoglobin qib thiab mob zis,
cov pa oxygen nyob rau hauv huab cua,
lub thickness ntawm daim tawv nqaij uas lub ntsuas phoo thov,
o lossis o rau thaj tsam ntsuas.

Yog tias tus nqi tau tau yog qis dua 30 hli RT. Daim duab., Tom qab ntawd qhov tseem ceeb ischemia (oxygen starvation) ntawm ob txhais ceg tau kuaj pom. Qhov tseeb ntawm cov qauv ntawm transcutaneous oximetry tsis siab. Tab sis nws tseem siv, vim tias nws suav hais tias yog xov xwm ntau thiab tsis tsim teeb meem rau cov neeg mob.

Dexamethasone rau cov ntshav qab zib

Cov tshuaj "Dexamethasone" muaj ib tug xov tooj ntawm contraindications thiab hom II mob ntshav qab zib mellitus, ua ib qho ntawm lawv.

Cov tshuaj no yog hluavtaws hormone ntawm adrenal cortex, uas yuav tsum tau ua nruj me ntsis raws li kev qhia.

Yog li, thiaj li tsis ua rau kom mob hnyav ntxiv, cov neeg mob ntshav qab zib yuav tsum hu rau lub tsev kho mob thiab sab laj nrog tus kws kho mob ua ntej yuav pib kho Dexamethasone kho.

Steroid ntshav qab zib: cov tsos mob, kev kuaj mob thiab cov txheej txheem kho

Qhov ua rau cov piam thaj ntau ntxiv tuaj yeem yog lub caij nyoog ntev tshaj ntawm cov tshuaj steroid hauv cov ntshav. Hauv qhov no, kev kuaj mob ntawm cov ntshav qab zib steroid yog tsim.

Feem ntau feem ntau, qhov tsis txaus ntseeg tshwm sim vim yog cov tshuaj kho mob, tab sis nws kuj tseem tuaj yeem ua qhov tsis yooj yim ntawm cov kabmob ua rau muaj kev nce ntxiv hauv kev tso tawm cov tshuaj hormones.

Feem ntau, kab mob kev hloov pauv hauv cov metabolism ntawm cov roj carbohydrates yog qhov thim rov qab, tom qab kev tshem tawm yeeb tshuaj lossis kho ntawm cov kab mob ua rau, lawv ploj, tab sis qee qhov lawv tuaj yeem mob tom qab kev kho mob.

Qhov tshuaj phom sij tshaj plaws rau cov neeg muaj ntshav qab zib hom 2. Raws li kev txheeb cais, 60% ntawm cov neeg mob yuav tsum hloov cov tshuaj hypoglycemic nrog kev kho insulin.

Steroid ntshav qab zib - nws yog dab tsi?

Steroidal, lossis kev quav yeeb tshuaj, ntshav qab zib yog kab mob uas ua rau hyperglycemia. Qhov laj thawj rau nws yog qhov tshwm sim ntawm glucocorticoid cov tshuaj hormones, uas tau siv dav hauv txhua ceg ntawm cov tshuaj. Lawv txo qis cov haujlwm ntawm lub cev tsis muaj zog, muaj cov khoom ua rau lub cev tiv thaiv. Glucocorticosteroids muaj xws li Hydrocortisone, Dexamethasone, Betamethasone, Prednisolone.

Tsis ntev, tsis pub dhau 5 hnub, kev kho nrog cov tshuaj no tau sau tseg rau cov kab mob:

malignant hlav
cov kab mob rau cov leeg mob
COPD yog mob ntsws ntev ntev
gout nyob rau theem mob huam tuaj.

Lub sijhawm ntev, ntau dua 6 lub hlis, kev kho kab mob steroid tuaj yeem siv rau kev mob ntsws, mob plab, mob plab hnyuv, mob caj dab, mob caj dab thiab hloov khoom nruab nrog cev.

Raws li kev txheeb cais, qhov tshwm sim muaj ntshav qab zib tom qab siv cov tshuaj no tsis ntau tshaj 25%. Piv txwv, hauv kev kho mob ntsws, hyperglycemia yog pom hauv 13%, teeb meem ntawm daim tawv nqaij - hauv 23,5% ntawm cov neeg mob.

Nyob zoo Kuv lub npe yog Alla Viktorovna thiab kuv tsis muaj ntshav qab zib ntxiv lawm! Nws coj kuv tsuas yog 30 hnub thiab 147 rubles.coj qab zib rov qab mus rau qhov qub thiab tsis vam khom rau cov tshuaj tsis raug mob nrog ib pawg ntawm cov kev mob tshwm sim.

>>Kuv zaj dab neeg tuaj yeem nyeem ua ntej ntawm no.

Kev pheej hmoo ntawm cov ntshav qab zib steroid yog nce ntxiv los ntawm:

mob ntxiv rau hom mob ntshav qab zib hom 2 mob ntshav qab zib, thawj cov txheeb ze muaj ntshav qab zib,
Mob ntshav qab zib hauv lub cev thaum lub sijhawm xeeb tub ib zaug,
mob ntshav qab zib
rog dhau los, tshwj xeeb tshaj yog mob plab
polycystic lub zes qe menyuam,
hnub nyoog siab heev.

Kev txhaj tshuaj ntau dua yog siv ntau dua, qhov muaj feem yuav ntau dua ntawm cov ntshav qab zib steroid:

Koob tshuaj ntawm hydrocortisone, mg rau ib hnub

Muaj kev pheej hmoo ntawm tus kab mob, lub sijhawm

Vim li cas rau kev loj hlob

Muaj kev sib txuam ncaj qha multicomponent ntawm kev siv glucocorticoid thiab kev txhim kho cov ntshav qab zib steroid. Tshuaj hloov lub biochemistry ntawm cov txheej txheem noj nyob rau hauv peb lub cev, provoking ruaj khov hyperglycemia:

Lawv cuam tshuam rau kev ua haujlwm ntawm beta hlwb, vim tias cov tshuaj tua kab mob insulin tsawg dua, nws tso tawm rau hauv cov ntshav tau los ntawm cov lus teb rau cov ntshav qabzib.
Yuav ua rau muaj kev tuag ntau ntawm cov beta hlwb.
Txo cov tshuaj insulin ua haujlwm thiab, vim li ntawd, ua rau cov piam thaj hloov mus rau daim ntaub.
Txo cov glycogen tsim sab hauv lub siab thiab cov leeg.
Txwv tsis pub cov kev ua ub no ntawm cov tshuaj hormone enteroglucagon, uas txuas ntxiv txo kev tsim tawm ntawm cov tshuaj insulin.
Lawv nce nce ntawm kev tso tawm ntawm glucagon, ib qho tshuaj hormones uas ua rau tsis muaj zog ntawm insulin.
Ua kom gluconeogenesis - txheej txheem ntawm kev tsim kua nplaum los ntawm cov sib txuas ntawm cov tsis-carbohydrate qhov.

Yog li, insulin ntau lawm txo qis, yog li cov piam thaj tsis tuaj yeem nkag mus rau nws lub hom phiaj - hauv cov hlwb ntawm lub cev. Qhov khiav ntawm cov piam thaj mus rau hauv cov ntshav, ntawm qhov tsis sib xws, nce vim gluconeogenesis thiab qhov ua kom tsis muaj zog ntawm cov ntshav qab zib ntawm cov suab thaj hauv khw.

Hauv cov neeg muaj kev noj qab haus huv metabolism, insulin synthes nce ntxiv tom qab 2-5 hnub ntawm kev noj tshuaj steroids los them rau nws txoj haujlwm txo qis.

Tom qab kev txiav tawm ntawm cov tshuaj, cov txiav quav rov qab rau hauv lub hauv paus. Hauv cov neeg mob uas muaj kev pheej hmoo siab ntawm cov mob ntshav qab zib steroid, kev them nyiaj yuav tsis txaus, hyperglycemia tshwm sim.

Pawg neeg no feem ntau muaj "kev rhuav tshem" ua rau muaj ntshav qab zib mob ntshav qab zib.

Tus kab mob no tau muab ICD code ntawm 10 E11 yog tias pancreatic muaj nuj nqi qee yam khaws cia, thiab E10 yog tias cov beta hlwb cov pov thawj feem ntau tau rhuav tshem.

Nta thiab cov tsos mob ntawm cov ntshav qab zib steroid

Txhua tus neeg mob noj tshuaj steroids yuav tsum paub cov tsos mob tshwj xeeb rau ntshav qab zib:

polyuria - tso zis nce ntxiv,
polydipsia - lub zog nqhis dej, yuav luag tsis muaj zog tom qab haus,
zawv plab zom ziab, tshwj xeeb tshaj yog nyob rau hauv lub qhov ncauj,
rhiab, flaky tawv nqaij
nkees tas li lub xeev, txo kev kawm,
nrog rau qhov tseem ceeb vim tsis muaj cov tshuaj insulin - cov khoom hnyav poob zoo.

Yog tias cov tsos mob no tshwm sim, nws yog qhov yuav tsum tau los soj ntsuam kab mob ntshav qab zib steroid. Kev ntsuam xyuas tshwj xeeb tshaj plaws hauv qhov no yog kev kuaj ntshav qabzib.

Qee qhov xwm txheej, nws yuav qhia pom cov kev hloov pauv hauv cov metabolism hauv cov metabolism thaum ntxov li 8 teev tom qab pib noj cov tshuaj steroids. Kev kuaj mob tib yam nkaus rau lwm yam mob ntshav qab zib: qabzib tom kawg ntawm qhov ntsuas yuav tsum tsis siab tshaj 7.8 mmol / l.

Nrog kev nce siab rau 11,1 units, peb tuaj yeem tham txog kev cuam tshuam ntawm cov metabolism hauv lub cev, feem ntau tsis tuaj yeem hloov ua.

Hauv tsev, mob ntshav qab zib steroid tuaj yeem raug kuaj pom siv cov glucometer, qib theem 11 tom qab noj mov qhia qhov pib ntawm tus kab mob. Fasting qab zib yoo hlob tuaj tom qab, yog tias nws siab dua 6.1 units, koj yuav tsum hu rau tus kws endocrinologist mus kuaj ntxiv thiab kho mob.

Koj puas mob siab los ntshav siab? Koj puas paub tias kub siab ua rau lub plawv nres thiab ntaus cwj nrag? Li qub koj siab nrog ... Lub tswv yim thiab cov lus qhia hais txog tus qauv nyeem ntawm no >>

Cov tsos mob ntawm tus mob ntshav qab zib mellitus tuaj yeem tsis pom, yog li nws yog kev coj los tswj cov ntshav qab zib rau thawj ob hnub tom qab tswj hwm ntawm glucocorticoids. Nrog kev siv sijhawm ntev ntawm cov tshuaj, piv txwv li, tom qab hloov chaw, kev kuaj tau muab txhua lub limtiam rau thawj lub hli, tom qab ntawd tom qab 3 hlis thiab rau lub hlis, tsis hais muaj nyob ntawm cov tsos mob.

Yuav kho kab mob ntshav qab zib steroid li cas

Mob ntshav qab zib sterter ua rau muaj suab thaj ntau ntxiv tom qab noj mov. Thaum tsaus ntuj thiab sawv ntxov ua ntej noj mov, glycemia yog qhov nyob hauv thawj thawj zaug.Yog li, kev kho mob siv yuav tsum txo cov suab thaj thaum nruab hnub, tab sis tsis txhob ua kom tsis muaj mob rau cov ntshav ib hnub dhau hnub.

Rau kev kho mob ntshav qab zib mellitus, tib cov tshuaj siv yog siv rau lwm yam kabmob: hypoglycemic agents thiab insulin. Yog tias glycemia tsawg dua 15 mmol / l, kev kho mob pib nrog cov tshuaj siv rau ntshav qab zib hom 2. Cov piam thaj ntau dua qhia tias muaj kev cuam tshuam tseem ceeb hauv kev ua haujlwm hauv pancreatic, cov neeg mob zoo li no tau raug sau tshuaj insulin.

Tshuaj zoo:

Tshuaj	Nkaus
Metformin	Txhim kho qhov kev xav ntawm insulin, txo qis qis gluconeogenesis.
Derivatives ntawm sulfanylureas - glyburide, glyclazide, repaglinide	Tsis txhob xaj tshuaj rau ntawm kev nqis tes ua lub sijhawm ntev, saib xyuas kev noj zaub mov kom tsis tu ncua yog qhov yuav tsum tau ua.
Glitazones	Nce insulin rhiab heev.
Cov qauv ntawm GLP-1 (enteroglucagon) - exenatide, liraglutide, lixisenatide	Zoo dua li mob ntshav qab zib hom 2, ntxiv cov insulin tso tawm tom qab noj mov.
DPP-4 inhibitors - sitagliptin, saxagliptin, alogliptin	Txo cov piam thaj hauv qab, txhawb nqa poob phaus.
Kev kho tshuaj Insulin, nyob ntawm theem ntawm lawv tus kheej insulin, kev coj noj coj ua tshuaj lossis qhov hnyav yog xaiv	Nruab nrab lub cev insulin feem ntau yog hais tawm thiab luv luv ua ntej noj mov.

Kev Tiv Thaiv

Kev tiv thaiv thiab tshawb pom lub sijhawm mob ntshav qab zib steroid yog qhov tseem ceeb ntawm kev kho mob nrog glucocorticoids, tshwj xeeb tshaj yog thaum lawv siv ntev yuav tsum. Kev ntsuas tib yam uas tau siv rau cov ntshav qab zib hom 2, kev noj zaub mov kom tsis tshua muaj carb thiab ua kom lub cev muaj zog, txo qhov kev pheej hmoo ntawm cov zaub mov carbohydrate cuam tshuam.

Hmoov tsis zoo, lub caij nyoog no tsis yooj yim rau kev ua tiav, vim tias cov tshuaj steroids ua rau kom qab los noj mov, thiab ntau yam kab mob uas kho lawv tshem tawm lossis txo kev ncaws pob. Yog li, hauv kev tiv thaiv cov kab mob ntshav qab zib steroid, lub luag haujlwm tseem ceeb rau kev kuaj mob ntawm kev tsis sib haum xeeb thiab lawv txoj kev txhim kho ntawm theem pib nrog kev pab los ntawm cov tshuaj muaj suab thaj.

Nco ntsoov kawm! Koj puas xav hais tias cov ntsiav tshuaj thiab cov insulin yog tib txoj kev ua kom tswj qab zib? Tsis muaj tseeb! Koj tuaj yeem soj ntsuam qhov no koj tus kheej los ntawm kev pib siv ... nyeem ntxiv >>

Dexamethasone ntsiav tshuaj - cov lus qhia ua haujlwm rau kev siv, analogues

Steroid ntshav qab zib tso cov khoom ntawm 2 thiab 2 hom. Nws zoo sib xws rau hom 1 hauv qhov ntawd beta hlwb raug puas tsuaj los ntawm corticosteroids hauv lub txiav.

Tab sis txawm nyob hauv lub xeev no, kev tsim cov tshuaj insulin tseem tab tom ua. Sij hawm dhau mus, nws cov nyiaj tsawg zuj zus thiab nyob rau tib lub sijhawm, cov hlwb ntawm lub cev maj mam tso tseg qhov kev paub tshuaj no, uas yog yam muaj rau cov ntshav qab zib hom 2.

Tsis ntev xwb txhua cov keeb (beta cells) tuag tas. Thiab nyob ntawm seb lawv puas tseem nyob hauv lub txiav ua paug ntawm qee qhov ntau lossis tsis, cov tshuaj insulin tuaj yeem tsim nyob rau hauv cov koob tshuaj me me, uas tseem tsis txaus.

Tus neeg mob xav tau insulin hauv kev txhaj tshuaj, thiab qhov no twb yog hom 1 (insulin-dependant).

Mob ntshav qab zib tshuaj muaj cov tsos mob zoo ib yam li cov paub:

kev nqhis dej
nquag tso zis
tsis tsim nyog nkees.

Cov yam ntxwv ntawm tus kab mob thiab cov tsos mob

Mob ntshav qab zib Steroid yog qhov tshwj xeeb hauv qhov nws ua ke ntawm cov tsos mob ntawm ob hom ntshav qab zib thiab ntshav qab zib hom 1. Tus kab mob pib thaum muaj ntau ntawm corticosteroids pib ua kom puas rau pancreatic beta hlwb.

Qhov no zoo ib yam nrog cov tsos mob ntawm tus mob ntshav qab zib hom 1. Txawm li cas los xij, beta hlwb txuas ntxiv tsim cov tshuaj insulin rau qee lub sijhawm.

Tom qab ntawd, lub ntim ntawm cov tshuaj insulin poob qis, qhov mob siab ntawm cov ntaub so ntswg rau cov tshuaj no tseem cuam tshuam, uas tshwm sim nrog ntshav qab zib 2.

Sijhawm dhau sijhawm, beta hlwb lossis qee yam ntawm lawv raug rhuav tshem, uas ua rau nres ntawm kev tsim cov tshuaj insulin. Yog li, tus kab mob pib pib zoo ib yam li cov ntshav qabzib insulin tsis tu ncua 1. Ua rau tib cov tsos mob.

Cov tsos mob tseem ceeb ntawm ntshav qab zib mellitus yog tib yam li nrog txhua hom ntshav qab zib:

Nce tso zis
Tubneeb
Qaug zog

Feem ntau, cov kev mob tshwm sim tsis qhia ntau, yog li lawv tsis tshua mob siab rau. Cov neeg mob tsis tau ua kom poob ceeb thawj, zoo li hauv ntshav qab zib hom 1, kev kuaj ntshav tsis yog ib txwm ua rau nws muaj peev xwm ua kev kuaj mob.

Cov concentration ntawm cov piam thaj hauv cov ntshav thiab cov zis tsis tshua muaj qhov txawv. Ib qho ntxiv, tseem muaj qhov txwv tsis pub muaj acetone ntau hauv cov ntshav lossis zis yog qhov tsis tshua pom muaj.

Kho ntshav qab zib

Yog tias lub cev twb tsis tsim cov tshuaj insulin, ces siv ntshav qab zib tshuaj, zoo li ntshav qab zib hom 1, tab sis nws muaj cov yam ntxwv ntawm ntshav qab zib hom 2, uas yog, insulin tsis kam ntawm cov ntaub so ntswg. Tus mob ntshav qab zib no kho mob ntshav qab zib 2.

Kev kho yog nyob ntawm, thiab lwm yam, ntawm yam mob uas tus neeg mob muaj. Piv txwv, rau cov neeg rog dhau los uas tseem tsim cov tshuaj insulin, kev noj zaub mov noj thiab ntshav qab zib kom tsawg xws li thiazolidinedione thiab glucophage tau qhia. Ntxiv rau:

Yog tias muaj lub cev ua haujlwm pancreatic txo qis, tom qab ntawd cov kev qhia ntawm insulin yuav muab nws txoj hauv kev los txo cov load.
Thaum tsis tiav ntawm atrophy ntawm beta hlwb, dhau sijhawm, kev ua haujlwm pancreatic pib rov zoo dua.
Rau tib lub hom phiaj, kev noj zaub mov kom tsawg-carb yog qhov tau noj.
Rau cov tib neeg muaj qhov hnyav, noj zaub mov noj haus No. 9 raug pom zoo; cov neeg rog dhau los yuav tsum ua raws li kev noj haus zaub mov 8.

Yog tias tus txiav tsis tsim cov tshuaj insulin, tom qab ntawd nws raug sau los ntawm kev txhaj tshuaj thiab tus neeg mob yuav tsum paub txog kev txhaj tshuaj insulin kom raug. Kev tswj cov ntshav qab zib thiab kev kho mob tau ua tiav zoo ib yam li mob ntshav qab zib 1. Ntxiv mus, cov kab mob hlwb tuag tsis tuaj yeem rov qab tuaj.

Ib qho kev sib cais tshwj xeeb ntawm kev siv tshuaj kho mob rau cov ntshav qab zib yog qhov xwm txheej thaum nws tsis tuaj yeem tsis lees txais kev kho tshuaj hormone, tab sis tus neeg muaj mob ntshav qab zib. Qhov no yog tom qab lub raum hloov ntshav lossis muaj mob hawb pob hnyav.

Cov suab thaj tau tswj xyuas nyob ntawm no, raws li kev nyab xeeb ntawm cov txiav thiab theem ntawm cov ntaub so ntswg muaj feem cuam rau insulin.

Raws li kev txhawb nqa ntxiv, cov neeg mob tuaj yeem yog cov ncauj lus anabolic uas ua rau sib luag ntawm cov tshuaj glucocorticoid.

Ib qho kab mob ntawm daim ntawv no raug txheeb xyuas yog tias cov ntshav ntawm cov ntshav qab zib pib dhau 11,5 mmol tom qab noj mov, thiab ua ntej noj mov, kev ntsuas pom tau tias ntau dua 6 mmol. Nyob rau thawj theem, tus kws kho mob yuav tsum tsis suav txhua yam kabmob uas zoo ib yam hauv pawg no.

Txoj kev kho mob tuaj yeem yog cov tshuaj ib txwm los yog kev hnyav. Qhov thib ob yog qhov ua tau zoo dua, tab sis xav tau kev txawj tswj tus kheej los ntawm tus neeg mob thiab suav hais tias yog kim nyiaj txiag.

Steroid mob ntshav qab zib mellitus, nws cov laj thawj thiab cov tsos mob

Daim insulin-tiv thaiv tsis ua mob ntawm tus mob tsis tshwm sim vim kev noj zaub mov tsis zoo lossis rog dhau. Raws li txoj cai, lub hauv paus tseem ceeb yog lub caij nyoog siv cov tshuaj hormonal. Yog li ntawv thiaj li hu ua tshuaj muaj ntshav qab zib.

Steroid mob ntshav qab zib mellitus hauv cov tshuaj raug xa mus rau tsis yog-ntau hom ntawm tus kab mob no. Yog li, nyob rau theem kev loj hlob, nws yog qhov tsis muaj feem cuam tshuam nrog kev ua tsis zoo ntawm tus txiav thiab tshwj xeeb, cov islets ntawm Langerhans.

Yog tias tus neeg tsis muaj kev cuam tshuam nyob rau hauv cov metabolism ntawm carbohydrates ntawm qib cellular, thiab kev noj ntau dhau ntawm glucocorticoids tshwm sim, ces cov ntshav qab zib steroid feem ntau tau nce nyob rau hauv ib hom mob me. Thaum kawg ntawm kev kawm ntawm kev txais tos ntawm tshuaj hormonal, tus kab mob ploj.

Ntshav Qab Zib Hom II, ntaus cim los ntawm cov tshuaj hormones tsim txaus, ntau dua ib nrab ntawm cov neeg mob ntau xyoo dhau los mus ua ib hom tshuaj insulin.

Tshuaj tiv thaiv kab mob

Glucocorticoids. Dexamethasone, hydrocortisone hauv tshuaj yog siv los tiv thaiv mob rau mob caj dab, nrog rau kev kho kab mob autoimmune (eczema, lupus, thiab lwm tus) thiab mob hawb pob.

Tsis tshua muaj txiaj ntsig, kev kho mob tsis suav nrog glucocorticoids tom qab kuaj mob ntawm ntau yam sclerosis.

Cov tshuaj diuretic ntawm thiazide diuretics (Nefrik, Dichlothiazide).

Tus lej ntawm cov tshuaj ntxiv kom txhob muaj menyuam.

Cov tshuaj siv rau kev kho mob tom qab phais mob hauv lub raum, hauv kev hloov pauv tshwj xeeb. Tom qab hloov chaw, ib tus neeg yuav tsum noj tshuaj tiv thaiv kab mob rau tag nrho nws lub neej, vim tias lawv yuav muaj kev cuam tshuam rau cov txheej txheem mob hauv lub cev.

Feem ntau, lawv hem rau kev noj qab haus huv ntawm qhov hloov khoom nruab nrog.

Tau kawg, steroid ntshav qab zib mellitus tsis tshwm sim hauv txhua tus neeg mob noj cov tshuaj hormones, tab sis txawm li cas los xij kev kho mob hnyav ua rau muaj kev pheej hmoo.

Yog tias tus neeg tawm tsam cov keeb kwm yav dhau los ntawm cov tshuaj no muaj cov tsos mob ntawm daim ntawv ntau npaum ntawm tus kab mob, ces feem ntau nws yuav yog qhov pib pheej hmoo. Txhawm rau zam nws txoj kev txhim kho, nws raug nquahu kom nqa koj qhov hnyav mus rau theem li qub, kho koj li kev noj zaub mov thiab mus rau kis las.

Qhov kev tshwm sim thawj zaug yuav tsum yuam kom tsum tsis txhob siv cov tshuaj hormones ntev, yog tias ua tau rau qee kis.

Cov tsos mob tseem ceeb thiab qee qhov nta

Ib qhov tshwj xeeb yog qhov sib xyaw ua ke ntawm cov khoom ntawm ob hom mob ntshav qab zib. Nyob rau thawj theem ntawm txoj kev loj hlob, ib qho dhau heev ntawm corticosteroids pib ua kev puas tsuaj rau cov qe hlwb uas ua rau muaj kev sib cais rau cov islets ntawm Langerhans, uas cuam tshuam txog ntshav qab zib steroid nrog daim ntawv insulin-tiv thaiv. Dua li ntawm qhov no, lawv tseem tsim cov tshuaj hormones.

Tab sis tom qab ntawd qhov ntau ntawm cov tshuaj insulin txo qis, qhov cuam tshuam ntawm cov hlwb rau nws poob, zoo li hauv hom ob. Sij hawm dhau mus, cov qe hlwb tso tseg tsis ua haujlwm thiab tuag, feem, tus kab mob hloov zuj zus thiab zoo li tus qauv ntawm cov insulin-raws li daim duab ntawm tus kab mob.

Cov tsos mob feem ntau zoo ib yam li cov kab mob niaj zaus:

kev nkees, kev ua kom qis dua,
nqhis dej heev
siab diuresis.

Qee qhov xwm txheej, tus neeg mob tsis hnov txawm tias lawv pom, vim lawv pom lawv tus kheej tsis muaj zog. Corticosteroids yeej tsis ua rau kom lub cev tsis hnyav lossis qhov nws nce, thiab kev kuaj ntshav ua rau nws muaj peev xwm ua rau kev txheeb xyuas qhov tseeb. Cov concentration ntawm cov piam thaj hauv cov zis thiab cov ntshav yob ib qho tsis tshua muaj, acetone tsis tshua pom hauv kev tshuaj ntsuam.

Mob ntshav qab zib yog qhov ua rau tshuaj steroid

Hauv nws tus kheej, ib qho dhau heev ntawm corticosteroids cuam tshuam rau tib neeg kev mob tib yam nkaus. Ntxiv mus, tsis yog txhua tus neeg coj lawv poob mob. Cov tshuaj hormones no ua tsis zoo rau tus txiav txim ntawm tus neeg, tab sis kuj txo cov hauj lwm zoo ntawm cov tshuaj insulin, tsuas yog ua rau nws tsis ua haujlwm.

Beta cells ua haujlwm ntawm lub zog tshaj plaws los tswj cov ntshav qab zib kom zoo. Yog tias tus kws mob nqus dej zoo dua, tom qab tsis ntev nws yuav siv nws hnyav dua. Nrog rau kev txo qis hauv cov npaum li cas lossis kev tshem tawm tag nrho cov tshuaj, txhua cov txheej txheem metabolic tau zoo huv.

Tab sis yog tias ib tug neeg noj cov tshuaj hormones muaj ntshav qab zib, daim duab yuav ua tiav qhov txawv. Lub hlwb tau ploj mus rhiab rau insulin, ntsig txog, tus txiav tsis ua tiav nws txoj haujlwm. Vim li no, nws raug nquahu kom cov neeg mob ntshav qab zib tau siv corticosteroids tsuas yog tshwj xeeb.

Ib qhov teeb meem sib txawv kiag li yog thaum nws tsis tuaj yeem tsis lees txais cov tshuaj hormones, piv txwv, yog tias mob ntsws asthma. Ntawm no, tus neeg mob yuav tsum tau soj ntsuam nruj nruj ntau ntau ntawm cov piam thaj, nrog rau haus dej cawv anabolics uas qee qhov nruab nrab tsis zoo ntawm glucocorticoids.

Cov Teeb Meem thiab Kev Kho Mob Ntshav Qab Zib Steroid

Qhov laj thawj ntawm kev tshwm sim ntawm theem nrab insulin-tiv thaiv hom 1 mob ntshav qab zib mellitus (steroid) yog ntau dhau lawm ntawm corticosteroids (cov tshuaj hormones ntawm adrenal cortex) hauv cov ntshav.

Mob ntshav qab zib Steroid tuaj yeem tshwm sim los ntawm cov kev mob txaus ntshai, thaum lub sijhawm muaj ntau dua corticosteroids (Itsenko-Cushing's disease).

Lub hauv paus tseem ceeb ntawm tus kab mob yog lub caij nyoog kho nrog qee cov tshuaj hormonal.

Uas muaj mob txaus ntshai
Cov tsos mob
Kev tawm tsam

Steroid ntshav qab zib yog qhov muaj kev mob siab ntxiv vim nws tsis yog los ntawm teeb meem pancreatic. Cov neeg mob uas tsis muaj kev ua txhaum ntawm cov khoom noj ntawm lub cev carbohydrate, tab sis leej twg noj ntau dhau ntawm glucocorticoids, pib muaj kev mob ntshav qab zib mellitus hauv kev tshwm sim me uas ploj tom qab tsis siv tshuaj lawm.

Mus txog 60% ntawm cov neeg mob ntawm hom ob yog qhov pheej hmoo ua cov tshuaj insulin-tiv thaiv cov kab mob hauv daim ntawv ntawm cov tshuaj steroid.

Uas muaj mob txaus ntshai

Glucocorticoids (dexamethasone, prednisone, hydrocortisone) yog siv los tawm tsam cov txheej txheem hauv kev kho mob ntsws asthma, mob rheumatoid kev mob caj dab, qee yam kab mob autoimmune, xws li lupus erythematosus, eczema, pemphigus.

Corticosteroids yog siv nyob rau hauv kev kho mob ntawm ntau yam sclerosis thiab qee lwm yam kab mob neurological.

Cov tshuaj Corticosteroid yog siv rau hauv kev tiv thaiv kev tiv thaiv, tom qab hloov raum, thaum cov tshuaj no tau tawm los tiv thaiv kev tiv thaiv kab mob.

Cov kab mob ntshav qab zib tsis tshwm sim hauv txhua tus neeg uas siv corticosteroids, tab sis kev pheej hmoo ntawm kev muaj mob kuj nce ntxiv.

Tsis tas li ntawd, tus kab mob tuaj yeem txhim kho qhov tshwm sim los ntawm kev siv tshuaj ntev los ntawm cov tshuaj hormones thiab cov tshuaj diuretics (hypothiazide, nvidrex, nephrix, dichlothiazide).

Yog tias cov tsos mob tshwm sim thaum kho nrog tshuaj corticosteroid, kev tiv thaiv yuav tsum tau ua. Cov kev ntsuas no suav nrog: kev noj zaub mov kom zoo, kev tawm dag zog kom tsim nyog.

Cov tib neeg kev txom nyem los ntawm kev rog yuav tsum tau txo lawv qhov hnyav mus rau theem li qub.

Yog tias koj tab tom mob ntshav qab zib, koj yuav tsum ua tib zoo saib xyuas kev noj tshuaj hormonal.

Mob ntshav qab zib sterter muaj cov yam ntxwv ntawm ob hom thawj thiab hom thib ob. Tus kab mob cuam tshuam nrog kev puas tsuaj rau pancreatic b-hlwb los ntawm corticosteroids (zoo li hauv ntshav qab zib hom 1). Tib lub sijhawm, b-cells rau qee lub sijhawm txuas ntxiv kev zais ntawm cov kua dej.

Tom qab, qhov ntim ntawm cov tshuaj insulin poob qis, cov ntaub so ntswg cov tshuaj tiv thaiv los ua cov tshuaj hormone kuj poob zuj zus (raws li qhov tshwm sim ntawm hom ob). Sij hawm dhau mus, cov cell b raug muab pov tseg tag los yog ib nrab raug rhuav tshem, insulin zais cia tsis muaj lawm.

Txij tam sim no, cov ntshav qab zib tshuaj mus yuav ua ib yam li ntshav qab zib hom 1.

Tubneeb
Nkees
Nquag mus tso zis thiab mus tso zis.

Feem ntau, cov tsos mob ntawm tus mob yog mob sib khuav, lawv tsis yog mob hnyav. Hauv kev sib piv rau hom ntshav qab zib hom 1, cov neeg mob ntshav qab zib mellitus feem ntau tsis tshua yuag poob. Kev kuaj ntshav tsis yog ib txwm qhia tias muaj tus kabmob, vim theem ntawm cov piam thaj thiab acetone hauv cov zis thiab ntshav feem ntau tsis dhau qhov ib txwm muaj.

Txawm hais tias muaj ntau dhau ntawm adrenal cov tshuaj hormones yog qhov pheej hmoo, tsis yog txhua tus neeg mob noj tshuaj corticosteroid muaj mob. Corticosteroids ua ob txoj hauv kev: lawv cuam tshuam cov txiav thiab txiav cov nyhuv ntawm cov tshuaj insulin. Hauv qhov no, yuav kom tswj hwm cov ntshav qab zib kom ib txwm muaj, cov txiav ua haujlwm kom ua raws li qhov ua tau.

Rau qee lub sijhawm, tus txiav ua ke tuaj yeem tiv taus qhov kev nrawm no, yog li tom qab ua tiav ntawm chav kawm corticosteroids, teeb meem metabolic ploj. Ntawm cov ntshav qab zib, cov nqaij mos ua lub ntsej muag rau insulin thiab pancreatic kev ua haujlwm yog qhov tsis taus. Hauv qhov no, corticosteroids tuaj yeem noj tsuas yog tias nws tshwm sim los ntawm kev siv khoom tseem ceeb.

Kev Pheej Hmoo Loj:

Kev siv tshuaj ntev ntev ntawm corticosteroids,
Noj tshuaj steroids hauv siab
Ntau zaus ua rau cov ntshav qab zib cov ntshav tsis paub vim li cas
Muaj cov rog ntawm tej degree.

Nws tshwm sim hais tias kev siv cov glucocorticoids provokes qhov kev mob ntshav qab zib, uas tsis tau paub ua ntej dhau los vim tias lub cev tsis muaj zog lossis tsis muaj nws cov tsos mob.

Nyob rau hauv cov xwm txheej zoo li no, muaj qhov pheej hmoo ntawm qhov ua kom tsis muaj zog hauv tus neeg mob lossis tseem hnov mob.

Yog li, ua ntej pib txoj haujlwm ntawm kev kho mob nrog tshuaj steroids (tshuaj tiv thaiv, diuretic thiazides), cov neeg rog rog, thiab tib neeg ntawm cov hnub nyoog laus dua, yuav tsum kuaj ntshav qab zib.

Kev tawm tsam

Thaum insulin secretion tau nres hauv lub cev, tus kab mob kis tau zoo sib xws rau cov ntshav qab zib ntawm thawj hom, txawm li cas los xij, muaj cov tsos mob ntawm hom ob, uas yog, insulin tsis kam ntawm cov ntaub so ntswg. Mob ntshav qab zib Steroid yog kho tau zoo li mob kab mob thib ob. Cov hau kev ntawm kev kho mob nyob ntawm kev qhia tseeb ntawm tus kab mob.

Qee zaum txhaj tshuaj insulin me me rau qee lub sijhawm. Kev txwv tsis pub ua haujlwm pancreatic xav tau kev siv tshuaj insulin raws li tus txheej txheem txhawb nqa.

Raws li qhov tshwm sim, cov hlau ua haujlwm nrog tsawg dua kev thauj khoom, thiab yog tias tseem muaj "nyob" b-hlwb, nws yog ib qho ua tau kom rov qab txiav ua tiav.

Rau cov hom phiaj kho, pluas noj cov zaub mov uas tsis muaj carbohydrates yog tau sau tseg: yog tias qhov hnyav yog qhov qub - kev noj haus 9, rau cov muaj kev txom nyem los ntawm kev hnyav dhau - zaub mov 8.

Qib thiab qab zib zoo ib yam li kho ntshav qab zib hom 1. Xws li tus kabmob no, kev kho lub luag haujlwm ntawm b-hlwb tsis muaj peev xwm.

Muaj qee kis thaum qhov tsis kam lees ntawm kev kho mob hormonal yog tsis yooj yim sua, piv txwv li, tom qab lub raum hloov ntshav lossis hauv cov neeg mob asthmatic. Nyob rau hauv cov xwm txheej zoo li no, lub xeev pancreas thiab cov ntaub so ntswg teb rau insulin raug coj mus rau hauv tus account kom tswj hwm cov khoom qab zib xav tau. Ntawm lwm cov tshuaj, cov neeg mob tau sau tshuaj anabolics uas them rov qab rau qhov tshwm sim ntawm glucocorticoids.

Steroid ntshav qab zib: ua rau

Steroid mob ntshav qab zib mellitus, lossis kab mob ntshav qab zib insulin-tiv thaiv kab mob ntshav qab zib mellitus 1, tshwm sim vim ntev ntev ntau ntawm cov tshuaj hormones hauv cov ntshav ntawm adrenal cortex - corticosteroids.

Qee lub sij hawm nws tsim tawm raws li kev cuam tshuam ntawm cov kab mob hauv kev tsim cov tshuaj hormones no, piv txwv, Itsenko-Cushing's disease, muaj kev ua tau zoo dua. Tab sis ntau zaus, tus kab mob ua rau nws tus kheej hnov tom qab ntev kho nrog qee yam tshuaj hormonal, yog li ib qho ntawm nws cov npe yog ntshav qab zib tshuaj.

Los ntawm nws cov keeb kwm, cov ntshav qab zib steroid yog hais txog cov neeg uas muaj mob ntxiv los ntawm tus kab mob, uas yog, nws tsis yog pib cuam tshuam nrog kev cuam tshuam ntawm tus txiav.

Hauv cov tib neeg tsis muaj qhov ua tsis taus cov carbohydrate metabolism, nrog kev siv tshuaj ntau ntawm cov qog adrenal (glucocorticoids), nws tshwm nyob rau hauv ib daim ntawv me me thiab ploj mus tom qab lawv tau tso tseg. Hauv 60% ntawm cov neeg mob uas muaj ntshav qab zib hom 2, tus kab mob no tuaj yeem ua rau muaj kev hloov pauv ntawm cov tshuaj insulin-ywj pheej rau ib hom tshuaj insulin.

Cov tshuaj twg ua rau cov ntshav qab zib steroid?

Cov tshuaj Glucocorticoid - Hydrocortisone, Prednisolone, Dexamethasone - yog siv los ua cov tshuaj tiv thaiv kev kho mob rau mob caj dab, rau kev kho mob ntsws asthma thiab qee cov kab mob autoimmune.

Qhov no, piv txwv, lupus erythematosus, pemphigus, eczema. Lawv kuj tseem siv rau hauv kev kho mob ntawm cov mob hlwb (neurological) xws li ntau yam mob sclerosis ..

Qee qhov siv tshuaj kho mob, xws li thiazide diuretics Dichlothiazide, Hypothiazide, Nifaisrix, Navidrex, qee cov tshuaj tiv thaiv kev xeeb menyuam, tuaj yeem dhau los ua cov ntshav qab zib tshuaj.

Cov koob tshuaj loj corticosteroids tseem siv rau kev kho mob tom qab lub raum hloov.

Tom qab hloov chaw, tib neeg siv tshuaj rau kev tawm ntawm kev tiv thaiv kev tiv thaiv rau lub neej, yog li ntau yam kev hloov pauv muaj ntau nyob rau hauv lawv, thiab ua ntej ntawm txhua qhov kev hem thawj ntawm cov hloov khoom nruab nrog.

Tshuaj mob ntshav qab zib tsis tshwm sim hauv txhua tus neeg mob, tab sis vim los ntawm cov tshuaj hormones tsis tu ncua, nws qhov tshwm sim hauv qhov no ntau dua li thaum lawv kho lwm yam kab mob.

Cov cim ntawm ntshav qab zib uas tshwm sim thaum noj tshuaj steroids qhia pom tias cov neeg no muaj kev pheej hmoo.

Txhawm rau kom tsis txhob mob, cov neeg rog yuav tsum nqa lawv qhov hnyav mus rau qhov qub, thiab cov uas muaj lub cev nyhav yuav tsum mob siab rau kev tawm dag zog lub cev thiab txhim kho lawv cov zaub mov noj kom tsawg. Tau kawm txog nws qhov kev rov ua dua rau "kab mob qab zib", koj tuaj yeem tsis noj ib qho tshuaj hormonal tswj tsis tau.

Cov tsos mob thiab cov yam ntxwv ntawm tus kab mob

Cov yam ntxwv ntawm cov mob ntshav qab zib steroid yog tias nws txuas cov khoom ntawm ob hom ntshav qab zib thiab hom ntshav qab zib hom 2. Nws pib nrog qhov tseeb tias ntau dhau ntawm corticosteroids ua rau kev puas tsuaj rau beta hlwb ntawm tus txiav (raws li nyob rau hauv hom 1 ntshav qab zib), txawm hais tias lawv txuas ntxiv tsim cov tshuaj insulin mus ntev Cov.

Tom qab ntawd tus nqi ntawm cov tshuaj insulin poob qis, thaum lub siab ntawm lub cev nqaij mus rau cov tshuaj no yog cuam tshuam (xws li hauv ntshav qab zib hom 2). Maj mam, beta hlwb los yog ib feem ntawm lawv raug rhuav tshem thiab tso tseg tsim cov tshuaj insulin, thiab tus kab mob pib pib txoj kev ib yam li cov insulin-muaj ntshav qab zib ua kom zoo li qub 1.

Cov tsos mob tseem ceeb ntawm ntshav qab zib mellitus yog qhov tseem ceeb tib yam nkaus li muaj qee yam ntshav qab zib - nqhis dej, tso zis muaj zog ntau ntxiv, qaug zog. Tab sis, raws li txoj cai, lawv tsis muaj zog, thiab qee zaum lawv tsis mloog.

Tsis zoo li hom ntshav qab zib hom 1, cov neeg mob tsis poob ceeb thawj, thiab txawm tias kuaj ntshav tsis tas yuav ua rau koj nrhiav kom paub qhov mob sai sai.

Qib ntawm cov ntshav qab zib thiab cov piam thaj hauv cov zis tsis tshua tau txog qhov txwv, muaj cov tshuaj acetone hauv cov ntshav thiab tso zis tsawg tsawg li tsawg.

Ntshav qab zib yog qhov pheej hmoo txaus ntshai rau cov ntshav qab zib steroid

Cov tshuaj hormones adrenal ntau heev yog tib yam hauv txhua tus neeg. Vim li cas txhua tus neeg tsis noj tshuaj glucocorticoids poob qis mob steroid ntshav qab zib? Corticosteroids, ntawm ib sab tes, ua rau ntawm tus txiav, thaum ob, lawv "nruab nrab" cov kev ua ntawm insulin. Yog li, txhawm rau kom cov ntshav qab zib kom qis nyob li qub, cov txiav yuav tsum ua haujlwm kom tsis txhob poob.

Kev txiav txim siab ntawm tus neeg noj qab nyob zoo rau qee lub sijhawm tiv thaiv lub nra hnyav, thiab sai li sai tau nws tsum tsis siv tshuaj steroids los yog txo cov koob tshuaj, cov teeb meem metabolic yuav ploj.

Tab sis yog tias koj muaj ntshav qab zib, tom qab ntawd qhov rhiab ntawm cov ntaub so ntswg mus rau insulin yog twb txo, thiab tus txiav tsis tuaj yeem tiv thaiv nws txoj haujlwm.

Yog li, koj tuaj yeem raug kho nrog steroids tsuas yog rau kev mob nkeeg. Txoj kev pheej hmoo nce:

nrog lub caij nyoog siv steroids,
nyob rau hauv cov ntaub ntawv ntawm lawv siv nyob rau hauv high koob,
nyob rau hauv muaj qhov hnyav tshaj.

Koj yuav tsum tau ceev faj ib yam nkaus rau cov neeg uas, rau qhov tsis paub meej, qee zaum nce ntshav qab zib. Qee zaum thaum siv glucocorticoids, ntshav qab zib ua tau nws tus kheej, uas tus neeg mob tsis tau paub txog, txij li nws mob sib khuav.

Hauv qhov no, cov tshuaj tiv thaiv tshuaj hormonal tuaj yeem ua rau mob sai sai thiab txawm ua rau tsis nco qab lawm.

Yog li, ua ntej sau cov tshuaj hormones uas tsis cuam tshuam txog kev kho mob (tshuaj txwv, tshuaj mob thiazide pawg), cov poj niam rog dhau heev lawm thiab cov neeg muaj hnub nyoog siab yuav tsum raug kuaj mob ntshav qab zib latent.

Ultrasound ntawm cov hlab ntsha muab ntshav rau ob txhais ceg

Kev kuaj ntshav khov (cov duab hluav taws xob) ntawm cov hlab ntsha ntawm cov leeg ntshav qis - siv los ntsuas lub xeev cov ntshav ua ntej thiab tom qab ua tiav kev phais ntawm cov hlab ntsha. Txoj kev no ua rau muaj kev pheej hmoo ntau ntxiv uas nws muaj peev xwm nyob rau hauv lub sijhawm los kuaj txog kev cuam tshuam ntawm cov leeg los ntawm txoj hlab pas los yog kom rov qab lumen hauv cov hlab ntsha tom qab kev phais mob (rov qab kho dua).

Ultrasound ntawm cov hlab ntshav tso cai rau koj los kawm txog thaj chaw muaj teeb meem, uas yog ntu uas tau "txiav tawm" ntawm cov hlab ntshav vim qhov tshwm sim ntawm kev loj hlob ntawm tus kab mob. Siv cov txheej txheem no, koj tuaj yeem ua tib zoo xav txog cov xwm txheej ntawm cov hlab ntsha thiab npaj ua ntej kev ua haujlwm kom rov qab tau lawv lub luag haujlwm.

Xoo hluav taws xob xoo hluav taws xob sib txawv angiography

Xoo hluav taws xob xoo hluav taws xob xoo hluav taws xob yog kev soj ntsuam uas tus neeg sawv cev sib piv txhaj rau hauv cov hlab ntshav, thiab tom qab ntawd cov hlab ntsha yog "translucent" nrog xoo hluav taws xob. Angiography txhais tau tias "kev soj ntsuam vascular". Nov yog hom kev qhia tshaj plaws. Tab sis nws tsis kaj siab rau tus neeg mob, thiab tseem ceeb tshaj - tus neeg sawv cev tsis sib xws tuaj yeem ua kom lub raum puas. Yog li, nws raug nquahu kom siv nws tsuas yog thaum cov lus nug ntawm kev ua haujlwm phais los rov qab vascular patency yog txiav txim siab.

Qeb mob ntshav qab zib muaj teeb meem ntawm ob txhais ceg

Muaj 3 qib peripheral ntshav ntws cuam tshuam hauv cov neeg mob ntshav qab zib mellitus.

Qib 1 - tsis muaj cov tsos mob thiab cov tsos mob ntawm tus kab mob txog hlab ntsha hauv ob txhais ceg:

arterial yeej paub ntsoov
pob taws-brachial Performance index ntawm 0.9-1.2,
ntiv tes thiab lub xub pwg qhov taw qhia> 0.6,
transcutaneous oximetry tus nqi> 60 mmHg. Kos duab.

Theem thib 2 - muaj cov tsos mob lossis cov paib, tab sis tseem tshuav tsis txaus oxygen tshaib plab ntawm cov ntaub so ntswg:

sib quas ntus claudication (mob duav)
pob luj taws-brachial Performance index ntawm 30 hli RT. Kos duab.,
transcutaneous oximetry 30-60 hli RT. Kos duab.

Qib 3 - tseem ceeb oxygen tshaib plab ntawm cov nqaij (ischemia):

systolic siab nyob rau hauv cov hlab ntsha ntawm sab ceg qis Kev kho mob yog tias ob txhais ceg mob ntshav qab zib

Yog tias koj ob txhais ceg mob ntshav qab zib, tom qab ntawv kho yog 3 qhov qhia tias:

cuam tshuam rau yam tseem ceeb uas txhawb kev txhim kho atherosclerosis, suav nrog hauv cov hlab ntsha ntawm ob txhais ceg,
ua tib zoo siv cov lus pom zoo rau kev tiv thaiv thiab kho mob ntawm cov teeb meem ceg, uas tau tham hauv cov ncauj lus kom ntxaws hauv tsab xov xwm “Cov mob ntshav qab zib ko taw”
daws ntawm qhov teeb meem ntawm kev phais neeg txhawm rau kho ntshav kev hauv cov hlab ntsha

Txog thaum nyuam qhuav, nyob rau theem ntawm kev sib quas ntus, cov neeg mob tau raug tshuaj pentoxifylline. Tab sis kev tshawb fawb pom tau tias tsis muaj txiaj ntsig zoo rau cov neeg mob ntshav qab zib uas muaj kab mob txhaws.

Nrog rau cov teeb meem ntshav qab zib ntawm ob txhais ceg, phais kom rov qab los ntshav hauv cov hlab ntsha tuaj yeem tau txais txiaj ntsig zoo. Cov kws kho mob txiav txim siab rau lo lus nug ntawm nws txoj kev coj ua nrog txhua tus neeg mob, coj mus rau hauv nws tus kheej qhov kev pheej hmoo rau kev phais mob.

Cov neeg mob uas mob ceg mob ntshav qab zib, raws li txoj cai, tau tshaj tawm cov kev cuam tshuam ntawm cov metabolism carbohydrate (ntshav qab zib hauv ntshav siab heev), ko taw mob ntshav qab zib, nrog rau kev tshwm sim ntawm lwm cov kev mob ntshav qab zib. Txhawm rau pab lawv tiag tiag, koj yuav tsum koom nrog ib pab kws tshaj lij hauv kev kho mob.

Mob ko taw mob ntshav qab zib tau kho los ntawm tus kws kho tshwj xeeb (kom tsis txhob muaj kev nyuaj siab ntxhov plawv nrog kws kho mob). Ua ntej, kev phais mob ntawm kev mob ntawm ko taw tej zaum yuav tsim nyog los tiv thaiv kev txhawm chim, thiab tsuas yog tom qab ntawd - kev kho kom rov zoo li qub ntawm cov hlab ntsha.

Mob ntshav qab zib thiab mob ceg yam: nrhiav tau

Peb vam tias tsab xov xwm no tau piav qhia rau koj kom meej yuav ua li cas yog tias koj ob txhais ceg mob ntshav qab zib. Koj yuav tsum hloov mus rau lub neej noj qab haus huv nyob rau hauv thiaj li yuav ua kom normal ntshav qab zib thiab nres kev loj hlob ntawm atherosclerosis. Nrog kws kho mob, koj yuav muaj peev xwm txiav txim siab txog kev phais mob uas yuav ua kom rov qab tau qhov ywj pheej ntawm cov hlab ntsha ntawm ob txhais ceg. Koj kuj yuav tsum tau tshuaj ntsuam xyuas lwm yam kev mob ntshav qab zib thiab kho lawv.

Thov tsis txhob sim "muffle" qhov mob los ntawm lam puab nrog kev pab los ntawm ib co ntsiav tshuaj. Cov kev mob tshwm sim tuaj yeem cuam tshuam koj qhov mob thiab lub neej ntev dua. Sab laj tus kws kho mob tsim nyog. Ntawm cov ntshav qab zib, nws yog ib qho tseem ceeb kom ua tib zoo tswj kev tu cev ko taw txhawm rau txhawm rau ua kom muaj peev xwm txav "ntawm koj tus kheej."