Somogyi ndi matenda kapena matenda aakulu a insulin ambiri osokoneza (SKHPI): zizindikiro, matenda, mankhwalawa

Somogyi ndi matenda - ochepa chabe koma sioneka matenda, makamaka anthu otchuka akudwala matenda a shuga. Kodi kuzindikira ndi ngati mukhoza kuchiritsidwa?

The syndrome mfundo Somogyi

Mu shuga liyenela mawerengedwe olondola a mlingo wa insulin, koma nthawi zambiri kumakhala kovuta kuchita, zimene ana amakumana ndi mavuto. Zotsatira zake zimakhala zonse mankhwala ambiri osokoneza Somogyi syndrome. M'mawu ena, ndi matenda a insulin ambiri osokoneza aakulu. American wasayansi Michael Somogyi anaphunzira zodabwitsazi mu 1959 ndipo anapeza kuti madyedwe a Mlingo kwambiri wa thunthu amakwiya hypoglycemia - kuchepa madzi a shuga magazi. Apa tikutengegeredwa ku kukondoweza mahomoni ndi kontrinsulinovyh ayankhe - hyperglycemia linagawidwa (kuwonjezeka magazi shuga msinkhu).

Iwo likukhalira kuti panthawi iliyonse mlingo magazi insulin ndi apamwamba kuposa ankafunila, amene Ngati munthu zikubweretsa hypoglycemia, ndi wina - ku kudya. A kumasulidwa mahomoni amachititsa okhazikika alili kontrinsulinovyh mu mlingo shuga magazi, n'kuchititsa otaya osalimba a shuga, ndi kungachititse kuti ketonuria (acetone mu mkodzo) ndi ketoacidosis (Vuto la matenda a shuga).

mabuku a mbiri yakale

Insulin anali woyamba ntchito bwinobwino mu 1922, kenako anayamba kuphunzira mabuku a zotsatira zake pa thupi, ikuchitika zatsopano pa zinyama ndi anthu. Asayansi apeza kuti pamafunika mlingo waukulu wa mankhwala nyama chifukwa hypoglycemic mantha, zimayambitsa imfa. Iwo adapempha ambiri zotsatira poizoni wa timadzi thupi. Zaka zimenezo, mankhwala amagwiritsidwa ntchito pofuna kuchiza odwala matenda a anorexia kuti kuonjezera thupi lawo kulemera. Izi zinachititsa kuti zinthu zisinthe zonse madzi a shuga magazi, Kusiyana kwa hypoglycemia kuti hyperglycemia. Pa akamaliza njira ya mankhwala wodwala anasonyeza zizindikiro za matenda a shuga. A kuchita chimodzimodzi zinachitika mu maganizo zochizira odwala akuchita misala "zodabwitsa insulin". Chitsanzo pakati kuwonjezeka mlingo ndi kuonjezera insulin anasonyeza glycemia ndi wodwala matenda a shuga. zodabwitsazi wakhala wodziwika mu tsogolo ngati syndrome Somogyi.

zizindikiro

Monga kudzikonda kumvetsetsa kuti thupi poyera kuti ambiri osokoneza aakulu a insulin? syndrome Somogyi akuwonetseredwa ndi zizindikiro:

• pali kuwonongeka ambiri thanzi, pali kufooka,
• mwadzidzidzi mutu, chizungulire, amene angathe kwambiri pambuyo kudya zakudya chakudya,
• kutanganidwa tulo, amakhala ndi nkhawa ndipo chabe, nthawi zambiri zoopsa
• pali kumverera zonse kutopa, tulo,
• kudzuka m'mawa zovuta, anthu mantha,
• akhoza kuoneka kusawona bwino mu mawonekedwe a nkhungu akuona, chophimba kapena zikuthwanima mawanga owala,
• mmene alili, kawirikawiri malangizo oipa,
• kuchuluka kudya, kunenepa.

Zizindikiro oterowo modetsa nkhawa belu, koma lisakhale chifukwa zoonekeratu kuti matenda, monga zizindikiro za matenda ambiri. A chithunzi thunzi chokwanira cha njira kunachitika thupi unkagwiritsidwa mothandizidwa ndi mayesero.

diagnostics

Matendawa "Somogyi syndrome" kuthandiza zizindikiro ndi awa:

• maonekedwe a matupi ketone (acetone) mu mkodzo,
• lakuthwa, mofulumira zizindikiro kusinthasintha shuga msinkhu kuchokera otsika yapamwamba ndi kumbuyo kwa tsiku lonse,
• zolaula kapena silinatchulidwe hypoglycemia,
• bwino shuga chimfine,
• matenda a shuga worsens ndi kuwonjezeka mlingo wa insulin ndi bwino ndi kuchepa.

Somogyi syndrome matenda nthawi zambiri ndi kovuta ngakhale kwa akatswiri osati ndi m'thupi yemwenso upo angapereke zotsatira zolondola yomweyo. Ichi ndi chifukwa chakuti zizindikiro wodwalayo ndi matenda zimene zimachitika mu thupi lake, akhoza chizindikiro ngati overabundance wa insulin, ndi kuchepekedwa ake. Chithunzi matenda mu njira izi zofanana, aakulu ambiri osokoneza angathe kuonedwa kokha moyang'aniridwa nthawi zonse ndi aluso mosamala kusanthula. Matendawa zachokera zinthu monga mmene matenda ulaliki, kawirikawiri boma hypoglycemic, ndi kusinthasintha shuga magazi.

matenda masiyanidwe

Somogyi ku matenda a matendawa mosavuta kusokonezedwa ndi maonekedwe a chodabwitsa cha "mbandakucha", monga zizindikiro za pathologies izi azigwirizana. Komabe, pali kusiyana kwambiri. Chodabwitsa "mbandakucha" akupezeka osati odwala matenda a shuga, komanso anthu athanzi, iye anasonyeza m'bandakucha hyperglycemia. Ichi ndi chifukwa choti ndi milingo woyambira insulin chifukwa chiwonongeko mofulumira chiwindi kapena kumatheka amasulidwe contrainsular timadzi m'mawa. Mosiyana syndrome Somogyi, mawonetseredwe a zodabwitsazi si yoyamba hypoglycemia. Kuika matenda lolondola ndi kofunika kudziwa magazi shuga mlingo awiri kapena anayi m'mawa, odwala ndi matenda aakulu ambiri osokoneza ndi adatchithisira, ndi mu mtima ndi hyperglycemia m'bandakucha iye sasintha. Chithandizo cha matenda amenewa ndi zosiyana: zinalili poyamba, insulin mlingo yafupika, ndiye chachiwiri - kuonjezera.

Features a shuga mu syndrome Somogyi

Kuphatikiza a shuga ndi matenda cha mankhwala osokoneza bongo aakulu a insulin (SKHPI) amapereka zingawononge, matenda ndi zovuta kwambiri. Against maziko a zonse kulandira Mlingo kwambiri a hypoglycemia amakhala zobisika mawonekedwe. syndrome Somogyi mu shuga zimaonekera mu chikhalidwe ambiri wodwala, ndi makhalidwe ake.

kusintha mwadzidzidzi wa maganizo popanda chifukwa - chodabwitsa pafupipafupi matenda amenewa. Pamene masewera phunziro ntchito iliyonse kapena masewera patapita kanthawi munthuyo mwadzidzidzi wasiya kukonda zonse zikuchitika, amakhala aulesi ndi amphwayi, sanyalanyaza zinthu kunja. Nthawi zina unmotivated chakukhosi kapena mokwiya angayambe. Nthawi zambiri, pali kochulukira kudya wodwalayo, koma, ngakhale, nthawizina pali maganizo ofooketsa chakudya munthu akukana kudya. Zizindikiro zimenezi zimachitika 35% odwala. madandaulo ambiri monga kuukira kufooka, chizungulire, kupweteka mutu, tulo chisokonezo. Ena taonani mwadzidzidzi sakhalitsa zithunzi kuwonongeka (mu mawonekedwe a chophimba pamaso kapena yowala "ntchentche").

chithandizo

Chithandizo cha matendawa kumafuna Somogyi zolondola mawerengedwe a Mlingo insulin. Chifukwa chaichi, kuchuluka wovulala ayenera kusintha, izo yafupika ndi 10-20% pansi kuonerera okhwima wodwalayo. nthawi yaitali bwanji amaliona syndrome Somogyi? Malinga ndi munthu adziwe osiyana njira kudzudzulidwa ntchito - kudya ndi pang'onopang'ono. Choyamba imachitika pa masabata awiri zapitazo, wachiwiri kumatenga miyezi 2-3.

Koyamba, munthu akhoza kuganiza kuti kuchepetsa insulin mlingo zidzapangitsa kuti kutha kwa matendawa, koma izo siziri. Mere kuchepetsa kuchuluka kwa kutumikiridwa mankhwala si bwino mayendedwe a shuga, mankhwala ayenera kukhala zovuta. Zingamvekere chakudya (kuti matenda kuchuluka kwa chakudya ankadya chakudya), masewera olimbitsa thupi. Kapamba kutumikiridwa musanadye chakudya. Only njira mabuku kungabweretse zabwino polimbana ndi matenda Somogyi.

kaonedwe

Panthawi yake kudziwika matenda aakulu a insulin ambiri osokoneza ali Zoneneratu positive. Nkofunika dzisamalire, ndi chizindikiro cha thupi, kusintha kulikonse zokhudzana ndi kuwonongeka kwa thanzi yomweyo dokotala, mwachitsanzo, mu Center wa Endocrinology pa maphunziro (Moscow). Zotsatira zabwino za chithandizo cha mbali zofunika ankaimba ndi Luso zinachitikira dokotala. Pamene undiagnosed syndrome akumane Zoneneratu: ambiri osokoneza kopitirira insulin kokha kumawonjezera mmene wodwalayo, matenda a shuga likuipiraipira.

kupewa

Main SKHPI kupewa malo monga ya miyeso.

• Mu matenda a shuga ayenera mosamalitsa Pamilunguyo zakudya bwino chikufanana ndi wodwala ndipo amaonetsetsa chipukuta misozi cha zimam'patsa kagayidwe. Munthu ayenera kukonza chakudya, athe kuwerengera phindu la zimam'patsa chakudya ankadya popanga ndi m'malo chokwanira cha mankhwala ngati ndi kotheka.
• mankhwala insulin amachitika Mlingo chofunika kwa wodwala makamaka. ntchito dokotala - ngati n'koyenera kuti kukonza, wodwalayo - kuyan'ana zochitika za chamoyo.
• Zonse zolimbitsa thupi ndi kofunikira kuti odwala matenda a shuga, makamaka ngati wodwala amangokhala kapena KUKHALA-pansi ntchito.
• Zonse kuwunika matenda, ndi m'thupi yemwenso upo pa ndandanda munthu ndi akamavutika.
• Mokwanira ziyenera a chikhalidwe cha thupi, matenda, mofulumira kudziwika zizindikiro zolakwika.
• Chilengedwe cha zinthu kudziletsa pa moyo wawo, kuphunzira odwala ndi achibale mfundo za kudziletsa.

Somogyi syndrome ana

Ana amene akudwala matenda a shuga, sangathe nthawi zonse mungawononge kusintha mkhalidwe wa chamoyo, kawirikawiri izi sizotheka Choncho, kulamulira njira ya matenda - kusamalira makolo. Mosamala penyani kuti kugona mwana, ngati zochita za kapamba makamaka usiku, ndipo khalidwe mwana akhoza kumuuza kwambiri. Pamene chiwonetsero cha matenda a kugona zifika lotopetsa ndi chabe, limodzi ndi kupuma phokoso. Mwana akhoza kukuwa kapena kulira take chifukwa malubwelubwe. Atauka lolemera, atangotha kumachitika chisokonezo.

mawonetseredwe onsewa - chizindikiro cha chikhalidwe hypoglycemic. tsiku lonse mwanayo amakhalabe boma flaccid, iye ndi capricious, kukwiya, alibe chidwi masewera kapena maphunziro. Mphwayi angagwe mwadzidzidzi popanda chifukwa, m'kupita kwa gawoli. kubuka kawirikawiri mokwiya unmotivated, mmene alili ndi osadalirika. Nthawi zambiri, ana ndi matendawa amadwala matenda. Chithandizo ikuchitika pa mfundo zofanana ndi za akulu. Zamaphunziro Center wa Endocrinology pa Mwachitsanzo, umathandiza ana kulimbana ndi matenda Somogyi.