Alcohol hypoglycemia - tsarin haɓakawa da yadda za'a kawar dashi

A. Janar bayani.Shan barasa abu ne sananne wanda ke haifar da mummunan rashin kuzari a cikin jarirai da ƙananan yara. Yaro na iya yin natsuwa shan giya daga wani dattijo yayin bikin. A wannan yanayin, yawan zubar jini yawanci yakan faru da safe. Wasu lokuta iyaye sukan bawa yaransu giya ko giya.

B. Pathogenesis. Canza maye daga ethanol zuwa acetaldehyde an ɗauke shi ne ta hanyar guba mai guba. Maganin wannan enzyme shine NAD - wani abu ne mai mahimmanci don gluconeogenesis. Ciwan Ethanol yana haifar da saurin kashe kudi na NAD da kuma mummunar hana gluconeogenesis a cikin hanta. Ethanol yana haifar da hypoglycemia kawai bayan sa'o'i 6-8 na matsananciyar yunwa (lokacin da samar da glycogen a cikin hanta ya ƙare).

B. Jiyya. Tare da mai laushi ko matsakaici hypoglycemia, an ba wa yaron abin sha da abinci mai wadatar glucose. Ana kawar da matsanancin rashin ƙarfi na jini ta hanyar ƙwayar glucose na ciki. Bayan harin guda ɗaya na hypoglycemia, idan an kafa gaskiyar shan giya, ba lallai ba ne a bincika ɗan.

Viii. Magungunan ƙwayar cuta.Hypoglycemia a cikin yara na iya lalacewa ta hanyar gabatarwar insulin, magunguna masu rage yawan sukari ko manyan allurai na salicylates. Acid din acid din tare da abubuwanda ke haifar da shi yana hana hada hadarin kitse mai guba, wanda hakan ke haifar da karancin gluconeogenesis da rashi na carnitine mai rauni. Acidaryewar ƙwayar ƙwayar cuta ta valproic acid da abubuwanta na iya bayyana kansa azaman hypoglycemia ba tare da ketonemia da ketonuria ba, musamman bayan yunwar.

Gudanar da insulin wani nau'i ne na cutar da yara. Hakanan yana faruwa cewa iyaye suna ba da insulin ga yaro, suna zargin suna da insulin-insulin-da ke ɗauke da ciwon sukari. Hypoglycemia wanda ya haifar da insulin da maganganun maganganu na baki shine yawanci yana haɗuwa da tashin hankali da asarar hankali kuma ana iya rikicewa tare da sauran nau'in hypoglycemia.

IX. Idiopathic mai juyayin hypoglycemia - wani nau'in hypoglycemia wanda ya haifar da ƙwayar abinci (duba kuma babi na 34, p. VIII). Wannan nau'in cututtukan hypoglycemia yawanci ana zargin shi a cikin yara da matasa, amma da wuya a tabbatar da bayyanar cutar. Bayyanar cututtukan idiopathic reactive hypoglycemia an kafa shi ne a sakamakon sakamakon gwajin haƙuri na ƙuruka: 3-5 awanni bayan shan glucose a ƙaddarar 1.75 g / kg (matsakaicin 75 g), yawan taro na glucose a cikin jini

Yadda giya ke tsokanar cututtukan cututtukan zuciya

Halin ethanol a cikin jini kwalliya ce:

• Da farko dai, yana kara ayyukan insulin da allunan rage sukari.
• Tahanyar hanta, ethanol yana hana samar da glucogen - ƙarin tushen glucose.
• Hanyar aikin giya mai kama da ayyukan lipids: yana narke mai, yana ƙaruwa da girman ƙwayoyin mai. Ta hanyar faɗaɗa ƙwayoyin ƙwayoyin cuta, glucose daga jini yana shiga cikin tantanin halitta. Lokacin da abin da ke cikin jijiyoyin jikinsu ya fadi, matsananciyar yunwar ta bayyana.

Bugu da kari, ethanol yana gyara aikin haɓakar hormone kuma yana karkatar da cikakkiyar amsawar jiki ga canje-canje na ƙwayar plasma. Wannan shine ɗayan abubuwan da suka fi haifar da cututtukan jini a cikin mutanen da ke shan giya, kamar yadda hormone girma ke sarrafa glucometer.

Godiya ga "adadin kuzari" wanda waken ethanol ya ƙunshi, hakan yana hana amfani da mai mai.

Hanyar haɓakar ƙwayar tsotsar jini

Masu ciwon sukari da ke da "ƙwarewa" na cutar sun san game da yiwuwar rage yawan giya. Matsayin glucose ya hau a cikin hanyoyi biyu: tare da cin abinci na carbohydrates tare da abinci da kuma ta hanyar samar da glycogen ta hanta. Rashin aikin glucose mai ƙarfi yana tallafawa matakan sukari na akalla 3.3 mmol / L. Idan barasa yana hana gluconeogenesis ta hanyar toshe hanta, tunanin me zai faru da jiki lokacin da ba'a fitar da glucose ba. Samun damar samun hauhawar jini ya fi yawa a cikin masu ciwon sukari da ke dogara da su, tunda daidaita kashi don yin la’akari da mai maye bashi da sauki.

Ethanol yana haifar da hypoglycemia saboda rushewar tsarin gluconeogenesis tare da canji a cikin cytosolic rabo NAD H2 / NAD. Gudun giya a cikin hanta yana ɗaukar lalata dehydrogenase. Maganin haɗin enzyme, NAD (nicotinamide adenine dinucleotide) abubuwa ne masu mahimmanci na glucogenesis. Yawan shan barasa a cikin tsarin jijiyoyin jiki yana haifar da amfani da yawan aiki na NAD da kuma toshe hancin glycogen a hanta.

Babu shakka, hypoglycemia na giya yana haɓakawa da ƙasan asali na raguwar albarkatun glycogen, lokacin da ƙarfin hanta zuwa glucogenesis yana da matukar muhimmanci ga daidaituwar sukari. A haɗarin mutane masu shan giya koyaushe tare da rage cin abinci.

Cutar cutar sankara ta hypoglycemic state

Alcoholism shine sharadin akai-akai don haɓakar ƙayyadadden jini don ɓangaren waɗanda aka cutar ba tare da binciken cutar sankara ba. Da farko, an ƙididdige irin wannan ƙididdigar ta wurin ƙazamtattun abubuwa waɗanda ke ɗauke da drinksa drinksan abin sha mai ƙarfi. Amma bayan gwaje-gwajen da aka samu da ethanol, waɗanda aka ba da cikakkiyar lafiya masu sa kai waɗanda suka yi fama da farauta na kwana biyu ko uku kuma suka nuna irin wannan sakamakon, dole ne a canza wannan ra'ayi.

Yawancin cututtukan cututtukan ƙwayar cuta ana samun su a tsakanin masoya giya waɗanda ba tare da abun ciye-ciye ba na kwana ɗaya ko biyu. Rikici yana tasowa a cikin sa'o'i 6 zuwa 24 bayan ethanol ya shiga cikin jini, don haka ba daidai bane a binciki wani hari ta ƙanshin daga bakin, binciken dakin gwaje-gwaje ya zama dole. Akwai tarihin alamun bayyanar cututtuka a cikin nau'i na yawan amai, wannan yana nuna haushi daga tsarin juyayi da ciki tare da giya, ƙarancin kalori lokacin da waɗannan abubuwan abinci waɗanda ke dauke da ethanol suka shiga ciki.

A hadarin, a matsayin mafi yawan saurin kamuwa da cututtukan shaye-shaye:

• Insulin dogara da masu ciwon sukari,
• Marasa lafiya tare da cututtukan da ke cikin tsarin pituitary-adrenal,
• Yaran da suka sami damar shan giya kwatsam.

Hadarin dake faruwa na cututtukan cututtukan zuciya da kuma halin halin halin ɗimawar jiki a cikin yara na yearsan shekaru 5. Yawan mutuwa na ethanol na yara shine 3 g / kg (a cikin manya - 5-8 g / kg).

Alcohol-induced na jinin haila yawanci yakan ƙare a cikin coma. Yana da wuya a rarrabe wannan jihar daga mummunan guba.

Alcohol hypoglycemia yana halin mahimman alamu na asibiti:

Gwajin hepatic yana nuna al'ada, yana yiwuwa a bincika yanayin kawai ta hanyar tarihin shan barasa da aka lura a cikin anamnesis. Bayan maido da albarkatun glycogen, tsokanar giya ba ya haifar da cututtukan jini.

Hypoglycemia tare da tushen giya ya dogara da kashi-kashi: yawan wanda aka kashen ya dauka, ana tsawatar da glucogenesis. Na musamman haɗari shine jinkirta nau'in hypoglycemia. Idan da yamma ya sha mai ƙarfi na giya, rikicin na iya faruwa da dare. Saboda ƙarancin maida hankali na glycogen a cikin hanta, wannan yanayin yana da wuyar magani. Shan giya yana ba da gudummawa ga watsi da bayyanar cututtuka na abubuwan da ke faruwa na rashin lafiyar hypoglycemia, saboda haka, ba a ɗaukar matakan da suka dace don kawar da su.

Yadda za a kawar da nau'in barasa mai guba

Ba tare da bincike na kan lokaci ba da kuma kulawar da ta dace da gaggawa, ana lura da mace-mace a cikin wannan yanayin a cikin 25% na yara da 10% na wadanda suka balaga.

Ta hanyar gabatarwar glucagon, matsalar da maye ta shaye shayen baza'a iya warware ta ba, tunda babu sauran glycogen ajiyar, gami da yadda jikin ya dauki wannan hormone din. Injections na glucose suna da tasiri don rage matakan lactate da daidaita ma'aunin acid-base. Ba kamar sashi na tsarin hypoglycemia ba, mara lafiya baya buƙatar ci gaba da glucose. A cikin yara waɗanda ke da irin wannan bayyanar cututtuka, suna farawa da glucose, kuma dropper tare da maganin glucose-electrolyte ya cika shi.

A matsayin taimakon farko (idan wanda aka azabtar yana sane) an ba shi damar amfani da carbohydrates mai sauri - Sweets, ruwan 'ya'yan itace mai dadi. Relapses na hypoglycemia ana hana shi tazara adadin carbohydrates. Allunan glucose suna dauke da daidaitattun adadin carbohydrates.

Hanya mafi kyau don kawar da kwayar cutar mahaifa shine hanawa:

1. Masu ciwon sukari suna buƙatar rage shan barasa.
2. Barasa ba zai iya zama wata hanya ba don rage ƙwayar cutar glycemia.
3. Tare da ingantaccen hanta, an ba shi izinin cin 50 g vodka da cognac ko 150 MG na busassun giya (babban ma'aunin sha shine rashin sukari da ƙananan adadin kuzari).
4. Wani lokaci zaku iya shan giya - har zuwa 300 g (cutar da carbohydrates tana biya sakamakon fa'idodin yisti na giya).
5. An haramta duk abin sha mai ƙarfi mai zaki - kayan zaki da giya mai ƙarfi, barasa, giya, da sauransu. Ga mata masu juna biyu, babu wani zaɓi cikin wannan batun: an haramta shan giya bisa manufa.
6. Ka tuna cewa masaniyar barasa tana nuna alamun shigowar ɗimin jini, gami da jinkirta. Gargadi game da matsalolinku ga wadanda suke wannan lokacin.
7. Ya kamata a cinye abincin giya bayan cin abinci.
8. Kafin tafiya barci, tabbatar cewa yin cikakken bayani don sukari kuma ku ci wani abu tare da carbohydrates.
9. Lokacin yin lissafin adadin kuzari na abincin ku, la'akari da adadin kuzari na barasa: 1 g na furotin ko carbohydrates - 4 kcal, 1 g na mai - 9 kcal, 1 g na ethanol - 7 kcal.
10. Kasance cikin shiri don gaskiyar cewa barasa zai ƙara maida hankali ga triglycerides, haɓaka bayyanar da alamun cututtukan jijiyoyin mahaifa a cikin cututtukan cututtukan zuciya.