Somogyi kuti urwere kana chirwere chirwere insulin yakakodzera ovhadhozi (SKHPI): zviratidzo, chirwere, nokurapa

Somogyi kuti chirwere - isingawanzowanikwi asi achinyengera chirwere, kunyanya vanhu vakakurumbira chirwere cheshuga. Sei kuziva uye kana unogona kurapwa?

Pfungwa chirwere Somogyi

In chirwere cheshuga kunoda kwakarurama kukarukureta pamusoro dose insulin yakakodzera, asi kazhinji zvingatiomera kuita, izvo hwakazara matambudziko. Mugumisiro anova kugara zvinodhaka ovhadhozi Somogyi syndrome. Mune mamwe manzwi, ndiye ane chirwere chirwere insulin yakakodzera ovhadhozi. musayendisiti American Michael Somogyi akadzidza Fani iyi muna 1959 uye vakagumisa kuti yaunodya wokunzwa mishonga yacho fuma chinokurwadzai yomuropa - vasanyanye muropa shuga yomuropa. Izvi zvinotungamirira kuna kweiyi hormone kontrinsulinovyh mhinduro - hyperglycemia rebound (kuwedzera ropa shuga pamwero).

Zvakaratidza kuti chero nguva muropa jekiseni pamwero wakakwirira kupfuura zvandinenge, izvo mumwe nyaya kunotungamirira yomuropa, uye mune imwe - kuti nokudyisa. A kusunungurwa mahormone kunokonzera zvechigarire kontrinsulinovyh ndatsamwa muropa shuga pamwero, kuparadza kusagadzikana chokubuda cheshuga, uye zvingaita kuti ketonuria (acetone mu weti) uye ketoacidosis (kuomesa kwakaita chirwere cheshuga).

nhoroondo zvinhu

Jekiseni yakatanga kushandiswa zvinobudirira muna 1922, pashure iro rakatanga misoro kudzidza migumisiro yayo pamusoro muviri, akaita kwakaita mhuka uye vanhu. Masayendisiti akawana kuti dzakakwirira mishonga yacho mushonga kwemhuka kukonzera hypoglycemic kuvhunduka, kazhinji zvichiita kuti rufu. Rakanga pfungwa vazhinji chepfu anokonzerwa kemikari pamuviri. Mumakore iwayo epakuvamba, mushonga ichishandiswa kurapa varwere vane neanorexia kuti vawedzere muviri uremu hwavo. Izvi zvakaita kuti dzose kuchinja ropa shuga yomuropa, kusiyana kubva yomuropa kusvikira hyperglycemia. Panopera yawapiwa murwere akaratidza zviratidzo cheshuga. A ndozvinoitawo kwakaitika wepfungwa nokuda pakurapa varwere schizophrenia "jekiseni ukapisa murwi". Pattern pakati kuwedzera uwandu husingakuvadzi uye kuwedzera jekiseni vakaratidza glycemia uye nokurapa chirwere cheshuga. Fani iyi ngakuzivikanwe mune ramangwana sezvo Somogyi syndrome.

zviratidzo

Somunhu nokuzvidzora kunzwisisa kuti muviri pachena kuti chirwere ovhadhozi insulin yakakodzera? Somogyi chirwere kunoratidzwa zviratidzo:

• pane vakawanda Kuipa utano, pane simba,
• kungoerekana nemusoro, dzungu, izvo zvinogona zvinoshamisa kutevera Mishonga yaunodya pamusoro makabhohaidhiretsi,
• vavhiringidzike hope, inova mwoyo uye asingafungi, kazhinji kurota zvinotyisa,
• pane kuramba manzwiro kuneta, nehope,
• padzinomuka mangwanani zvakaoma, vanhu vanonzwa vapererwa nemhosva,
• anogona kuonekwa chiono Blurred muchimiro mhute pamberi pameso ake, chifukidziro kana kuvheneka zvivara,
• Zvinyamusi, kazhinji munhu akaipa mirayiridzo,
• wakawedzera Nzara, kufuta.

Zviratidzo kwakadaro anovhundutsa bhero, asi murege kuva pachena chikonzero chirwere, sezvo tiri zviratidzo zvirwere zvizhinji. A mufananidzo zvakakwana kwemasayendisiti kuitika mumuviri inogona kurondwa tichibatsirwa nemiedzo.

Diagnostics

Chirwere "Somogyi chirwere" kubatsira zviratidzo aya:

• pakuonekwa miviri ketone (acetone) iri weti,
• unopinza uye nokukurumidza nokufamba shuga pamwero zviratidzo kubva pasi kusvikira kumusoro uye shure kusvikira zuva,
• yakajeka kana zvakakwana yomuropa,
• nani shuga nokuti chikosoro,
• zveshuga Zvinoipisisa pamwe kuwedzera mishonga insulin yakakodzera uye anovandudza pamwe kuderera.

Somogyi chirwere chirwere kakawanda kwakaomera kunyange nyanzvi, kwete hayo endocrinologist kubvunza anogona kupa akarurama zvabuda pakarepo. Izvi imhaka yokuti murwere zviratidzo uye zvinetso kuti kuitika mumuviri wake, anogona chiratidzo ive overabundance insulin yakakodzera, uye ayo dhefisiti. The kunotoda mune azvaiitwa akafanana, chisingaperi ovhadhozi anogona kuonekwa bedzi pasi kugara achitarisirwa uye unyanzvi Kunyatsodzidza inoongorora. Chirwere kunobva zvinhu zvakadai hwokufananidzira kunotoda mharidzo, kakawanda hypoglycemic mamiriro, yakakwirira ropa shuga nokufamba pamusoro.

differential kuongorora chirwere

Somogyi mu nechirwere pamusoro chirwere chiri nyore kuvhiringidzwa zvinoratidza Chiitiko kuti "mambakwedza", sezvo zviratidzo izvi pathologies maviri akafanana. Zvisinei, pane zvinokosha kusiyana. Chiitiko kuti "mambakwedza" rinowanikwa kwete chete pane varwere cheshuga, asiwo vanhu utano, akaratidza mambakwedza hyperglycemia. Izvi imhaka kushayikwa basal jekiseni siyana nokuda kuparadzwa nokukurumidza wake chiropa kana kunowedzera kusunungurwa contrainsular kemikari mangwanani. Kusiyana Somogyi urwere, kuratidzwa Fani iyi haisi pakurukurwa yomuropa. Kuisa zvakarurama chirwere zvinokosha kuziva ropa shuga pamwero maviri mana mangwanani, mune varwere chisingaperi ovhadhozi chirwere zvinonzi chichiburutswa, uye ari kushivirira hyperglycemia mambakwedza haachinji. Mishonga yezvirwere izvi akasiyana: mumutsetse wokutanga, asi jekiseni dose ipfupi, ipapo wechipiri - kuwedzera.

Zvakakurukurwa cheshuga ari urwere Somogyi

Tikafunga cheshuga aine chirwere echirwere ovhadhozi insulin yakakodzera (SKHPI) rinopa tigume, chirwere chacho kwakandiomera. Tikafunga kugara nokugamuchira kunyanyisa mishonga ine yomuropa anova Isimba rakadini rinogona kubudiswa chimiro. Somogyi chirwere muna cheshuga kunooneka mukuru ezvinhu omurwere, uye ake maitiro.

Chimbichimbi rokuchinja manzwiro pasina chikonzero - a kakawanda chakajairika urwere kwakadaro. Apo zvinhu chidzidzo bhizimisi chero kana mutambo mushure chinguva murume pakarepo anorasikirwa kufarira zvose zvichiitika, zvinova usimbe uye vasingakendengi, hanya nechitarisiko ezvinhu. Dzimwe nguva unmotivated chigumbu kana utsinye anogona kuitika. Kakawanda, pane zvakawanda kushumba mune murwere, asi, pasinei ichi, dzimwe nguva pane mafungiro nezvokudya, murume anoramba kudya. Zviratidzo izvi zvichiitika 35% wevarwere. More zvakafanana zvichemo zvinosanganisira utera kurwiswa, dzungu, kutemwa nomusoro, hope nyonganyonga. Vamwe cherechedza pakarepo uye pfupi kutadza kuona zvakanaka (muchimiro chifukidziro pamberi kana chivara "nhunzi").

mabatiro

Pakurapa chirwere hunosanganisira Somogyi kwakarurama kukarukureta insulin yakakodzera mishonga. Nokuti chinangwa ichi, mari dzakabatwa zvinofanira kugadziridzwa, zviri kuderedzwa 10-20% pasi zvachose pakuongorora murwere. Rinhiko ikarapwa Somogyi chirwere? Zvichienderana munhu anoratidza siyana kururamiswa unyanzvi hunoshandiswa - kutsanya uye anononoka. First kuitwa mumakore mavhiki maviri, wechipiri zvinoda 2-3 mwedzi.

Pakutanga, mumwe angafunga kuti zvinoderedza jekiseni dose kuchatungamirira kunyangarika ari urwere, asi hazvisi. Mere zvinoderedza uwandu raitongwa zvinodhaka hakurevi kuvandudza nzira chirwere cheshuga, marapirwo anofanira kuva dzakaoma. Zvinokanganisawo kudya (kuti normalize chitsama makabhohaidhiretsi rapera chikafu), kurovedza muviri. Jekiseni chinotarisirwa usati wadya. Chete misoro nzira inogona pave zvakanaka pakurwisana urwere Somogyi.

mataridzikiro

Panguva Chaiyo kuonekwa echirwere chirwere insulin yakakodzera ovhadhozi ane Zvaifungidzirwa zvakanaka. Zvakakosha kuti zvichengetedze, ivo anonongedzera muviri, chero chinzvimbo kuchinja uye Kuipa utano pakarepo kubvunza chiremba, somuenzaniso, muna Centre momuviri panguva Yedzidzo (Moscow). The yakanaka Zvaizobuda pakurapa chikuru basa reDare professionalism uye zvakaitika chiremba. Kana undiagnosed chirwere vanoshorwa Zvaifungidzirwa: kunopfuurira ovhadhozi insulin yakakodzera chete achiipa mamiriro murwere, nokuti chirwere cheshuga ari kuipa.

dziviriro

Main Kudzivirira SKHPI dzokugara zvinosanganisira kuva zviyero.

• In chirwere cheshuga vanofanira zvakasimba vakanamatira kudya zvakanaka vachiwirirana murwere uye kunovimbisa muripo kuti carbohydrate muviri. Munhu anofanira kuronga zvokudya zvenyu, kukwanisa kuverenga kukosha carbohydrate zvokudya wakapedza, kubudisa imwe yakakwana yaitsiva chigadzirwa kana zvakakodzera.
• Kubaya jekiseni chiri kuitwa mishonga inodiwa imwe murwere. basa chiremba - kana zvakakodzera kuti kururamiswa, murwere - kuongorora kuitika nhengo.
• Constant muviri zvakakodzera kuti varwere cheshuga, kunyanya kana murwere ari ndakagara kana vane basa vanogara-pasi.
• Kuramba zvichiongororwa of chirwere, imwe endocrinologist kubvunza munhu purogiramu nomumwe uye sezvinodiwa.
• Yakakwana tinyatsonzwisisa ezvinhu muviri, utano, kukurumidza kuziva miedzo fungidzira zviratidzo.
• Creation mamiriro ezvinhu kuti kuzvidzora muupenyu hwavo hwezuva nezuva, kudzidza kuvarwere uye vomumhuri mirawu kuzvidzora.

Somogyi urwere muvana

Vana vachitambura cheshuga, havangagoni arambe kuchinja mamiriro nhengo, kazhinji ichi hazvibviri, saka, kudzora nzira chirwere - vabereki vane hanya. Muchinyatsochenjerera kuti akarara mwana, sezvo zvinoitwa jekiseni riri kunyanya usiku, uye maitiro mwana anogona kuudza chaizvo. Kana nokuratidzwa chirwere kunorara rikawira chipatapata uye zvachero, achiperekedzwa kufema ruzha. Mwana anogona kuridza mhere kana mhere hope yake yakafanira kurota zvinotyisa. Chisinga- rinorema, pakarepo pashure zvinoitika kuvhiringidzika.

Kuratidza zvose izvi - chiratidzo hypoglycemic ezvinhu. All zuva mwana anoramba ari flaccid mamiriro, iye capricious, kutsamwa, haruna kufarira mitambo kana zvidzidzo. Nokusakendenga zvingaitika pakarepo, pasina chikonzero, mukufamba chirongwa. Kakawanda panomuka pamusoro unmotivated kurwisa, Zvinyamusi nezvimwewo. Kazhinji, vana vane chirwere vanotambura nokuora mwoyo. Treatment rinoitwa pasi ichocho sezvo kuti vanhu vakuru. Momuviri Center panguva Academic Somuenzaniso, kunobatsira vana kugonana urwere Somogyi.