Glycosylated haemoglobin hba1c ya rage
Ciwon sukari cuta ce mara nauyi, saboda haka yana da muhimmanci a fahimci haemoglobin da ke motsa jiki - menene wannan alama da kuma yadda ake yin irin wannan bincike. Sakamakon da aka samu ya taimaka wa likitan ya kammala ko mutumin yana da yawan jini a cikin jini ko kuma kowane abu ne na al'ada, wato, yana da koshin lafiya.
Glycosylated haemoglobin - menene?
An tsara shi HbA1C. Wannan alama ce ta nazarin halittu, sakamakon da yake nuna nuni a cikin tarowar glucose a cikin jini. Lokacin binciken da aka gudanar shine watanni 3 da suka gabata. Ana la'akari da HbA1C a matsayin mafi nuna alama mai mahimmanci fiye da haɓaka don abubuwan sukari. Sakamakon, wanda ke nuna glycated haemoglobin, an bayyana shi azaman kashi. Ya nuna rabon mahadi “sukari” a cikin jimlar adadin kwayoyin jini. Yawan kuɗi sun nuna cewa mutum yana da ciwon sukari, kuma cutar tana da rauni.
Binciken don maganin gemocosylated yana da fa'idodi da yawa:
- za a iya gudanar da binciken ba tare da yin magana da wani takamaiman lokaci na rana ba, kuma ba lallai ne a yi shi a kan komai a ciki ba,
- cututtukan cututtuka da karuwar danniya ba su shafar sakamakon wannan bincike,
- irin wannan binciken yana ba ka damar gano ciwon sukari a farkon matakin kuma fara magani a kan kari,
- Binciken yana taimakawa wajen yanke shawara game da tasirin magani ga masu ciwon sukari.
Koyaya, wannan hanyar bincike ta kasa takaice ba tare da faduwarsa ba:
- babban farashi - yana da farashi mai yawa idan aka kwatanta shi da bincike don gano sukari,
- tare da rage matakan hodar iblis, kwayar HbA1C yana ƙaruwa, duk da cewa a zahiri, matakin glucose na mutum ya kasance ƙarami,
- a cikin marasa lafiya da anemia, sakamakon da aka gurbata,
- idan mutum ya sha bitamin C da E, Sakamakon yana da ƙanƙanci.
Glycosylated haemoglobin - yadda za a ba da gudummawa?
Yawancin dakunan gwaje-gwaje suna gudanar da irin wannan binciken, suna yin gwajin jini a cikin komai a ciki. Wannan ya sauƙaƙa wa kwararru su aiwatar da bincike. Kodayake cin abinci ba ya gurbata sakamakon, yana da mahimmanci a ba da rahoton cewa ba a ɗauki jini a cikin komai a ciki ba. Binciken don maganin gemocosylated hemoglobin za a iya yi duka biyu daga jijiya da daga yatsa (dukansu ya dogara da tsarin mai nazarin yanayin). A mafi yawan lokuta, sakamakon binciken a shirye suke bayan kwana 3-4.
Idan mai nuna alama yana cikin kewayon al'ada, za a iya yin bincike mai zuwa a cikin shekaru 1-3. Lokacin da aka gano cutar sankara kawai, ana bada shawarar sake yin gwaji bayan watanni shida. Idan an riga an yi wa mai haƙuri rajista tare da endocrinologist kuma an wajabta masa magani, ana ba da shawarar yin gwajin a kowane watanni 3. Irin wannan mita zai ba da damar samun ingantaccen bayani game da yanayin mutum da kuma tantance tasirin aikin magani da aka tsara.
Glycated gwajin hawan jini - Shiri
Wannan karatun ya sha bamban da irin nasa. Don ƙaddamar da gwajin jini don glycosylated haemoglobin, ba kwa buƙatar shirya. Koyaya, abubuwan da zasu biyo baya na iya dan juya sakamakon (a rage shi):
Binciko don maganin gemocosylated (glycated) haemoglobin ya fi kyau a cikin dakunan gwaje gwaje da kayan aiki na zamani. Godiya ga wannan, sakamakon zai zama mafi daidai. Yana da kyau a lura cewa karatun a cikin dakunan gwaje-gwaje daban-daban a mafi yawan lokuta suna ba da alamun daban. Wannan saboda gaskiyar cewa ana amfani da hanyoyi daban-daban na ganewar asali a cibiyoyin likita. Yana da kyau a dauki gwaje-gwaje a cikin dakin binciken da aka tabbatar.
Eterayyadewar glycosylated haemoglobin
Har ya zuwa yau, babu wani ƙuduri guda ɗaya da ɗakunan gwajin lafiya za su yi amfani da shi. Determinationuduri na glycosylated haemoglobin a cikin jini yana gudana ta hanyoyi masu zuwa:
- ruwa na chromatography
- immunoturbodimetry,
- ion musayar kayan maye,
- nazarin nephelometric.
Glycosylated Hemoglobin - Al'ada
Wannan alamar ba ta da shekaru ko bambancin jinsi. Thea'ida ta glycosylated haemoglobin a cikin jini ga manya da yara an haɗu. Yana daga 4% zuwa 6%. Manuniya waɗanda ke da girma ko ƙananan alamar cutar. Specificallyari musamman, wannan shine abin da gemocolobin ya nuna:
- HbA1C ya kama daga 4% zuwa 5.7% - mutum yana da metabolism na metabolism don tsari. Zai yiwu a kamu da ciwon sukari
- 5.7% -6.0% - Wadannan sakamakon sun nuna cewa mai haƙuri yana cikin haɗarin cutar kansa. Ba a buƙatar magani, amma likita zai ba da shawarar rage cin abincin carb.
- HbA1C ya kama daga 6.1% zuwa 6.4% - Hadarin kamuwa da cutar siga yana da yawa. Yakamata mai haƙuri ya rage adadin carbohydrates da aka cinye da wuri-wuri kuma ya bi shawarar sauran likita.
- Idan mai nuna alama shine 6.5% - bayyani na farko game da cutar sankarau. Don tabbatar da shi, ƙarin takaddar jarrabawa an wajabta.
Idan an gwada glycosylated haemoglobin a cikin mata masu juna biyu, al'ada a wannan yanayin daidai yake da sauran mutane. Koyaya, wannan alamar zata iya canzawa tsawon lokacin haihuwar jariri. Dalilan dake tsokane irin wannan tsalle:
Glycosylated haemoglobin ya karu
Idan wannan mai nuna alama ya fi al'ada, wannan yana nuna mummunan matsaloli waɗanda ke faruwa a jiki. Hawan jini na glycosylated yana yawan kasancewa tare da alamomin masu zuwa:
- asarar hangen nesa
- tsawan rauni waraka
- ƙishirwa
- raguwa mai kaifi ko karuwa a jiki,
- karancin rigakafi
- urination akai-akai,
- asarar ƙarfi da rashin barci,
- lalatawar hanta.
Glycosylated haemoglobin sama da al'ada - menene ma'anar?
Karuwar wannan alamar ana faruwa ne ta hanyar dalilai masu zuwa:
- kasawa a cikin carbohydrate metabolism,
- abubuwan da ba sukari ba.
Jini ga haemoglobin zai nuna cewa mai nuna alama ya fi yadda aka saba, ga maganganun:
- a cikin ciwon sukari mellitus - saboda gaskiyar cewa tsarin rarraba carbohydrates yana rushewa kuma matakan glucose yana ƙaruwa,
- tare da guba barasa,
- idan mara lafiyar da ke fama da cutar sankara ba a sanya shi yadda ya kamata ba,
- da rashin isasshen baƙin ƙarfe,
- bayan zub da jini,
- a cikin uremia, lokacin da aka jefa carhemoglobin, wani abu ne mai kama da kayansa da tsarinsa zuwa HbA1C,
- idan mai haƙuri ya cire cutar, ƙungiyar da ke da alhakin zubar da sel jajayen jini.
Cutar haemoglobin ta karu - me za ayi?
Glycosylated haemoglobin (HbA1C) alama ce ta biochemical ta nuna adadin a cikin jinin furotin na haemoglobin da ke da alaƙa da glucose. Yana ba da izini ga abin dogara, idan aka kwatanta da gwajin jini na yau da kullun don abubuwan sukari, don ƙididdige alamomin abubuwan da ke cikin abubuwan glucose na watanni 3 da suka gabata. Ya kamata a sani cewa yanayin HbA1C bai dogara da jinsi na mutum ba kuma iri ɗaya ne ga yara da manya.
Ofimar HbA1C tana da mahimmancin ganewar asali don gano asali na ciwon sukari mellitus da kuma lura da tasirin maganin cutar. Kari akan haka, ana yin wannan binciken yayin tantancewa:
- cuta cuta na rayuwa a lokacin ƙuruciya
- cututtukan mahaifa, wanda ke nuna karuwar glucose a baya, wanda aka bayyana a cikin mata yayin daukar ciki,
- nau'in 1 da nau'in ciwon sukari na 2 a cikin matan da suka sami juna biyu tuni a gaban wata cuta,
- ciwon sukari tare da bakin kofa mara kyau,
- bashin,
- nauyi na cutar kansa
- hauhawar jini, da sauransu.
Mahimmancin wannan bincike an ƙaddara shi ta hanyar binciken farko na cututtukan zuciya, haɓakar haɓakar jijiyoyin jini, gano rashi na gani, abin da ya faru na nephropathy da polyneuropathy, da sauransu. A Rasha, a kan shawarar WHO, ana amfani da irin wannan binciken tun daga 2011.
Tsarin bincike
Babban fa'ida a cikin binciken gemocosylated haemoglobin shine rashin shiri tun kafin isar da shi. Ana gudanar da binciken ne ta hanyar samfuran jini na cikin jini daga mai haƙuri, ko ta hanyar samfurin daga yatsa (dangane da nau'in mai nazarin) a cikin yawan 2-5 ml. A wannan halin, abin da ba a sani ba na iya faruwa, sakamakon aikace-aikacen yawon shakatawa da kuma amfani da samfurin jini.
Don hana coagulation, sakamakon ruwan da ke haifar da gauraye an haɗu da shi tare da anticoagulant (EDTA), wanda ke ba da gudummawar rayuwa mai tsayi (har zuwa mako 1) wanda ya dogara da wani tsarin zafin jiki (+ 2 + 5 0 С).
- ciki - sau ɗaya, a makonni 10-12,
- Type 1 ciwon sukari mellitus - 1 lokaci a cikin watanni 3,
- Type 2 ciwon sukari mellitus - 1 lokaci a cikin watanni 6.
An gudanar da bincike da kansa a cikin yanayin dakin gwaje-gwaje, inda, ta hanyar amfani da kayan aiki na musamman, an ƙaddara yawan ƙwayar cutar HbA1C. A wannan yanayin, ana amfani da hanyoyi masu zuwa:
- ruwa na chromatography
- zabin
- hanyoyin rigakafi
- Tarihin chromatography
- hanyoyin shafi.
Daga cikin kayan aikin da aka ambata na sama don amfani da ƙayyadaddun ƙwayar HbA1C, an ba da fifiko ga hanyar ƙwayar chromatography, tunda yana ba da babban inganci na ƙayyadaddun ƙayyadaddun ƙwayar glycosylated hemoglobin kuma don gano kasancewar karkacewarsa daga ƙa'idar da aka yarda.
Fassara Nazarin
Hanyar rarrabe dabi'u na haemoglobin ba mai wahala bane. Koyaya, fassarar alamomi na ƙarshe na iya zama da rikitarwa ta banbancin fasahar dakin gwaje-gwaje, haɗe tare da halayen mutum. Don haka, lokacin nazarin matakin haemoglobin glycated a cikin mutane biyu waɗanda suke da alamomin sukari na jini iri ɗaya, bambanci a cikin ƙimar ƙarshe na HbA1C na iya zuwa 1%.
A cikin gudanar da wannan binciken, yana yiwuwa a sami duka karuwar karya a cikin HbA1C, saboda karuwar hawan jini a cikin jini (halinsa a cikin manya ya kai 1%), kuma raguwar karya da ke faruwa a cikin cututtukan cututtukan cututtukan jini (ƙwararru da na kullum), uremia, da shima hawan jini.
Masana kimiyyar halittar dabbobi da masana kimiyyar binciken dabarun zamani sun gabatar da wani juzu'i game da amincin wannan alamar ga wasu nau'ikan mutane. Don haka, dalilai masu zuwa suna tasiri matakin sa:
- da shekaru mutum
- halaye masu nauyi
- nau'in jiki
- gaban concomitant cututtuka, da tsawon lokaci da tsananin.
Don dacewa da kimantawa, ana ba da ƙimar HbA1C a cikin tebur.
| Sakamakon bincike HbA1C,% | Fassara |
| Game da al'ada na binciken nuna
Kafin ka ziyarci ofishin likita don ba da gudummawar jini don ƙayyade matakin gemocosylated hemoglobin, ba kwa buƙatar aiwatar da takamaiman tsarin shirye-shirye. Kuna iya ɗaukar kayan halitta don gwajin dakin gwaje-gwaje a kowane lokaci, da safe da rana. Kafin ziyartar asibitin, zaka iya samun karin kumallo da kopin shayi ko kofi. Babu abincin da aka ɗauka kafin binciken, ko wasu dalilai waɗanda ke iya yin tasiri mai mahimmanci kan warware sakamakon bincikensa.
Wadannan kwayoyi suna cikin rukunin kungiyar magunguna kuma likitoci sun tsara su, don haka likitoci, a matsayin mai mulkin, suna sane da cewa sakamakon binciken da mara lafiyar yakeyi zai iya gurbata shi. Adadin gemocosylated haemoglobin a cikin jinin mutum mai lafiya bashi da kaso 5.7%. Yana da kyau a tuna cewa wannan alamar shine iyakar iyaka na yau da kullun, abin da ya wuce wanda zai iya nuna mawuyacin narkewar glucose. Wannan ka'ida ta dace ga mata da maza. Wasu dakunan gwaje-gwaje suna auna matsayin ba kawai yawan adadin haemoglobin da ke cikin jini ba, har ma da darajar sa. Kasancewar glycosylated haemoglobin a cikin jinin mutanen da ke da lafiya ya kamata ya canza cikin yanayin tunani wanda ya fara daga 1.86 kuma ya ƙare tare da 2.48 mmoles. Ka'ida ga mata da maza masu fama da kamuwa da cutar sankarau, amma tare da daidaito bin shawarar likitan don ci gaba da ƙoshin lafiya, yakai kashi bakwai zuwa bakwai da rabi.
Glycosylated haemoglobin a lokacin daukar ciki a cikin mata masu lafiya bai kamata ya zama sama da yadda aka riga aka sani ba 5.7%. Idan matakin wannan alamar ya tashi daga kashi 5.7 zuwa 6.4 cikin ɗari, to likitoci sun sanar da marasa lafiya game da yiwuwar kamuwa da cutar sankara. Idan a cikin gwajin jini nau'in haemoglobin na glycosylated ya zarce kashi 6.5 cikin ɗari, to kuwa ana bai wa marasa lafiya maganin farko na kamuwa da cutar sankarar bargo. Aboutarin bayani game da Ciwon sukariCiwon sukari, wanda yake shi ne nau'ikan guda biyu, cuta ce mai haɗari wanda zai iya haifar da lahani ga jikin mutum. Lokacin da sukari sukari na jini, jikin mai haƙuri ya fara gwagwarmaya tare da karuwar matakin, yana kunna iko daban-daban waɗanda ke hanawa (ko kuma a cire wani ɓangaren). Don rage haɗarin mummunar sakamakon cututtukan mellitus da dawo da ƙimar rayuwa mai kyau ga mutum ga wannan mutumin, ya kamata a yi amfani da magunguna na musamman da aka tsara. Misali, don daidaita ayyukan mutumin da ke fama da ciwon sukari na 1, an umurce shi da yin amfani da allura ta hanyar maganin insulin.
Mutanen da ke dauke da nau'in sukari na 2 na sukari masu tasowa ko haɓaka haƙuri a cikin jiki ana rubutasu allunan waɗanda ke da tasiri mai rage sukari ko haɓaka haɓakar glucose na nama. Ba daidai ba magani ko cikakken rashi na iya ƙara yawan sigar binciken akan lokaci. Lokacin da glycosylated nau'in haemoglobin ya haɗu, ana ganin yanayin da ake kira hyperglycemia a cikin marasa lafiya. Wannan yanayin ilimin halittu yana da wasu takamaiman alamu. Bayyanar cututtukan hyperglycemia (halayyar mutanen da ke fama da juriya na insulin kuma waɗanda suka tabbatar amma ba su da cikakkiyar cutar basir mellitus):
Na dabam, ya kamata a ambata cewa a wasu lokuta a cikin marasa lafiya da haemoglobin na nau'in glycosylated bazai iya ƙara ba, amma a rage. Tare da raguwa mai mahimmanci a cikin wannan alamar a cikin marasa lafiya, ana lura da canje-canje sosai a cikin kwanciyar hankali. Koyaya, yana da sauƙin sauƙaƙewa da ragewar ƙwayar glycosylated hemoglobin fiye da yanayin da wannan yanayin yake ƙaruwa. Abubuwan da suka fi haifar da raguwa mai yawa a cikin matakin glycosylated haemoglobin sune zubar jini mai yawa (gami da ciki) ko cutar rashin ƙarfi wanda ya taso sakamakon raunin ƙarfe. A wasu halaye, rage nau'in haemoglobin na iya zama saboda rashin amfani da magungunan da ake amfani da su don rama ga masu fama da ciwon sukari na 2, rage cin abinci na carbohydrate, ko wasu cututtukan ƙwayoyin cuta na musamman. Don dawo da nau'in gemocosylated hemoglobin zuwa al'ada, wanda ya isa ya saurari shawarar likita. Musamman, kuna buƙatar bin wani takamaiman tsarin "warkewa" da kuma jagorantar rayuwa mai kyau. Mutanen da ke da wannan alamar da ke ƙaruwa ya kamata su daina cin Sweets (ko kuma rage cin abincinsu) kuma rage yawan abincin da ke cikin carbohydrate a cikin abincin yau da kullun.
Mutanen da ke da haƙƙin glucose an gano su yayin gwajin jinin gwaje-gwaje don tantance nau'in haemoglobin ya kamata ya ɗauki magunguna na musamman waɗanda ke haɓaka jijiyar nama. Kulawa ta amfani da waɗannan magunguna yana nuna ingantaccen aiki kuma yana ba ku damar kula da lafiyar mutum, yana sauƙaƙe shi daga mummunan mummunan bayyanar cututtuka na hyperglycemia. Mafi sau da yawa, idan akwai matsaloli tare da narkewar ƙwayar glucose, an sanya magunguna, babban sinadaran aiki wanda shine metformin. Mafi yawan magungunan yau da kullun da aka saba amfani dasu na wannan aji ana ɗaukar su kudade da ake kira "Siofor" ko "Glucophage." Ana sayar dasu a cikin nau'ikan shirye-shiryen kwamfutar hannu suna da abun ciki daban-daban na abu mai aiki (kama daga ɗari biyar zuwa dubu milligrams). Bayyanar kowane alamun da ke iya nuna matsaloli tare da ɗaukar glucose wani lokaci ne na ziyarar babban likita. Bayan gano cikakken bayani game da yanayin mai haƙuri da kuma tattara sauran bayanan da suka wajaba don tara tarihin likita na farko, likitocin sun ba da izinin gwaje-gwajen dakin gwaje-gwaje na marasa lafiya, sakamakon abin da zai fayyace hoton kuma ya tsara daidai, kuma mafi mahimmanci, ingantaccen magani. Rashin cikakken daidaita matsalar na iya haifar da mummunan sakamako, bayyanar wacce ba za a iya guje mata ba. Wannan wane irin bincike ne wannan?Ofaya daga cikin ingantaccen bincike da ingantaccen bincike game da gano ciwon sukari shine bincike don tantance haɗakar HbA1C. Hakanan ana gudanar da irin wannan nazarin don lura da yanayin masu fama da cutar siga. Sakamakon yanke hukunci zai ba mu damar fahimtar yadda tasirin maganin da aka zaɓa yake, ko mara lafiya ya bi shawarar abinci ko kuma ya ƙi kulawa da shawarar likita. Abubuwan bincikeTa yaya gwajin haemoglobin da aka yiwa glycosylated ya fi gwajin sukari na yau da kullun? Ga fa'idodin mabuɗin:
Cons na bincikeKoyaya, binciken yana da nasa sakamakon, da farko:
Siffofin ganewar asali a cikin mata masu juna biyuYin amfani da bincike kan HbA1C don gano cutarwar mata yayin daukar ciki ba shi da tushe. Gaskiyar ita ce, wannan alamar za ta haɓaka ne kawai idan yawan haɗuwar glucose a cikin jini ya zarce na al'ada har tsawon watanni. Yaya ake yin binciken?Kamar yadda muka fada a baya, babban amfani da bincike shine cewa baya bukatar shiri. Ana iya ɗaukar bincike a kowane lokaci da ya dace, ba lallai ba ne a zo dakin gwaje-gwaje a kan komai a ciki.
YankewaBayyan sakamakon zai iya zama da wahala saboda banbancin fasahar bincike da halaye na mutum na marasa lafiya.
Idan mutum yana da abun da ke cikin HbA1C wanda kasa da kashi 5.7%, to wannan shine dabi'ance, kuma wannan nuna alama iri daya ce ga mata da maza. Idan bincike ya ba da irin wannan sakamakon, to, haɗarin kamuwa da cutar siga yana da ƙanƙanci. Idan dabi'ar ta wuce kadan (a tsakanin 5.7-6.0%), to zamu iya Magana game da haɗarin haɗarin kamuwa da ciwon sukari. Yakamata mutum ya sake nazarin abincinsa ya kuma ƙara yawan motsa jiki. Idan an ɗaga HbA1C zuwa 6.1-6.4%, to za a iya yin maganin cutar sankara. Ana yin bincike na farko game da ciwon sukari a farkon mataki idan mai nuna alama shine 6.5% ko sama. Ana buƙatar ƙarin nazarin don tabbatar da cutar. Dalilin karkacewaBabban dalilin cewa matakan HbA1C suna sama shine nau'in 1 ko nau'in ciwon sukari na 2. Bugu da kari, yanayin kayan zai iya wucewa a lokuta:
Wani yanayin da ake saukar da HbA1C shine anaemia hemolytic, wanda aka san shi da raguwar rayuwar rayuwar sel jini. A cikin marasa lafiya da ciwon sukari, ƙayyadaddun HbA1C ba ƙasa da 7% ba, idan ƙimar ta wuce, dole ne a daidaita jiyya. Don haka, gwajin jini don abubuwan da ke cikin gemocosylated haemoglobin shine bincike mai ba da labari. Haƙiƙar ita ce dabi'ar abubuwan da ke cikin wannan abun daidai ne ga duka mutane - maza, mata, matasa da yara. A wannan yanayin, alamu ba za su dogara da yadda mutum ya shirya tsaf don nazarin ba.
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Tunda lokacin daukar ciki, an lura da karuwar yawan sukari, a matsayinka na mai mulki, farawa daga watanni 6, ta amfani da bincike, kawai ana iya gano cutar kusa da haihuwa. A halin yanzu, yawan glucose na iya samun lokacin yin lahani, yana rikitar da lokacin daukar ciki. Sabili da haka, a lokacin daukar ciki, ana ba da shawarar yin amfani da wasu hanyoyin bincike, musamman, bincike na haƙuri haƙuri.
Ana iya ɗaukar samfurin jini daga jijiya da daga yatsa. Ya dogara gaba ɗaya akan nau'in mai nazarin da ake amfani dashi a cikin dakin gwaje-gwaje kuma baya shafar sakamakon. Don binciken, ya wajaba don ba da gudummawar jini na 2-5 na jini. Sau nawa yakamata a gwada ni?
Idan maida hankali na HbA1C ya zama ƙasa da yadda al'ada take buƙata, to wannan na iya nuna rashin lafiyar hypoglycemia. Bugu da ƙari, hawan glycosylated haemoglobin yana raguwa tare da zubar jini mai yawa da zubar jini.
