Cia peb kawm txog koj cov ammonia. Qhov no puas tuaj yeem ua rau muaj kev phom sij?

Muaj ntau yam tshwm sim hauv peb lub cev, puas yog? Cov khoom uas peb noj thiab haus yog zom, lub zog raug tsim tawm, thiab cov khib nyiab kuj raug tsim tawm. Yog li, cov ammonia no yog ib qho pov tseg uas tsim tawm hauv peb lub cev. Tab sis yog tias qhov no tsis raug tso tawm kom raug, nws tuaj yeem ua rau muaj teeb meem. Hnub no, cia peb tham txog cov ammonia no, vim li cas nws thiaj li txaus ntshai, thiab yuav ua li cas tswj nws.

Ammonia yog dab tsi? Hais yooj yim xwb...

Hais yooj yim xwb, ammonia, lossis (NH3), yog cov khoom pov tseg uas cov kab mob hauv peb txoj hnyuv tsim tawm thaum peb zom cov protein uas peb noj. Xav txog nws zoo li ib yam dab tsi uas tshuav los ntawm kev zom zaub mov. Yog li, koj puas paub tias feem ntau muaj dab tsi tshwm sim? Cov ammonia no mus rau peb lub siab . Lub siab zoo li lub Hoobkas zoo kawg nkaus hauv peb lub cev. Nyob ntawd, cov ammonia no raug ua tiav thiab hloov mus ua lwm cov khoom pov tseg hu ua urea . Tom qab ntawd, cov urea no mus rau peb lub raum , qhov chaw uas nws raug tso tawm hauv cov zis. Tag nrho cov txheej txheem no hu ua lub voj voog urea .

Tiam sis, xav txog seb puas muaj teeb meem hauv ib feem ntawm lub voj voog urea no, txawm tias nws yog lub siab, lub raum, lossis lwm yam uas pab cov txheej txheem no, ces cov ammonia tsis tau ua tiav thiab tso tawm kom raug. Thaum qhov ntawd tshwm sim, cov ammonia pib sib sau ua ke hauv cov ntshav. Thaum nws sib sau ua ke, nws kuj tuaj yeem mus ntawm cov ntshav mus rau lub hlwb. Tus nqi ntawm ammonia uas yuav tsum nyob hauv peb cov ntshav yog qis heev . Yog tias nws nce me ntsis, uas yog, yog tias muaj mob hu ua hyperammonemia tshwm sim, nws yog tshuaj lom heev rau peb lub paj hlwb hauv nruab nrab (CNS). Ntawd yog, nws yog qhov txaus ntshai.

Yuav tsum muaj ammonia ntau npaum li cas hauv lub cev?

Tam sim no, qhov ntau ntawm ammonia uas yuav tsum muaj nyob rau hauv cov ntshav ntawm ib tus neeg noj qab haus huv sib txawv raws li hnub nyoog. Cov menyuam mos tshiab muaj ntau dua li cov neeg laus me ntsis. Tsis tas li ntawd, seb tus menyuam yug thaum lub sijhawm lossis thaum ntxov kuj cuam tshuam rau nws.

• Cov menyuam mos noj qab nyob zoo uas tau teem caij : Kwv yees li 45±9 micromoles ib liter / micromol/L. Feem ntau, qhov txwv siab tshaj plaws yog ntawm 80 thiab 90 micromol/L.
• Cov menyuam mos uas yug tsis tau lub sijhawm : Kwv yees li 71±26 micromol/L. Qhov no yuav txo qis mus rau qib ib txwm tom qab li xya hnub.
• Cov menyuam yaus hnub nyoog tshaj ib hlis : Tsawg dua 50 micromol / L.
• Cov Neeg Laus : Tsawg dua 30 micromol/L.

Tab sis muaj ib qho uas yuav tsum nco ntsoov. Cov nqi no yuav txawv me ntsis ntawm chav kuaj mus rau chav kuaj. Yog li ntawd, nws yog qhov zoo tshaj plaws los piv rau cov nqi hauv koj daim ntawv qhia chav kuaj. Yog tias muaj teeb meem dab tsi,Nco ntsoov nug koj tus kws kho mob lossis tus nais maum.

Ammonia theem siab npaum li cas txaus ntshai?

Ammonia yog ib yam tshuaj lom heev . Feem ntau, cov ammonia hauv cov ntshav ntawm ib tus neeg laus noj qab haus huv tsawg dua 50 micromoles ib liter (micromol/L). Txawm li cas los xij, txawm tias qhov no nce mus txog 100 micromoles ib liter (100 micromol/L), kev hloov pauv hauv kev nco qab tuaj yeem pib tshwm sim. Qhov no txhais tau tias nws nyuaj rau kev tsom mus rau, thiab koj yuav dhau los ua me ntsis tsis meej pem. Yog tias cov ammonia hauv cov ntshav siab txog 200 micromol/L, koj yuav mus rau hauv lub xeev tsis nco qab thiab muaj qaug dab peg. Qhov no yog qhov txaus ntshai heev thiab tuaj yeem ua rau tuag taus.

Yuav ua li cas los xyuas cov ammonia hauv lub cev?

Koj tus kws kho mob tuaj yeem ntsuas koj cov ammonia nrog kev kuaj ntshav . Rau cov neeg laus, qhov no feem ntau ua los ntawm kev noj me ntsis ntshav los ntawm cov leeg ntshav hauv koj txhais caj npab. Rau cov menyuam mos, tus kws kho mob yuav ntxuav tus menyuam lub pob taws, xuas nws nrog ib rab koob me me, thiab haus ob peb tee ntshav. Tom qab ntawd, ib daim ntaub qhwv me me raug muab tso rau saum thaj chaw. Qhov no zoo li kev kuaj ntshav ib txwm muaj.

Cov tsos mob ntawm cov ammonia ntau yog dab tsi?

Yog tias koj cov ntshav ammonia nce ntxiv, koj yuav muaj cov tsos mob xws li:

• Kev tsis meej pem thiab kev tsis paub qhov chaw
• Pw tsaug zog ntau dhau, nyuaj sawv
• Kev hloov pauv hauv kev nco qab, qee zaum txawm tias poob kev nco qab
• Kev hloov pauv ntawm lub siab, kev chim siab, thiab kev hloov pauv ntawm lub siab
• Kev co tes, tshwj xeeb tshaj yog thaum ncab caj npab mus tom ntej
• Coma - lub xeev tsis nco qab thiab tsis teb

Qhov no tseem ceeb heev: yog tias koj lossis ib tus neeg ze koj muaj cov tsos mob no, tsis txhob nkim sijhawm thiab hu rau lub tsheb thauj neeg mob 1990, lossis mus rau chav kho mob ceev ntawm tsev kho mob ze tshaj plaws sai li sai tau. Cov ammonia ntau ntxiv tuaj yeem ua rau tuag taus, yog li kev kho mob tam sim ntawd yog qhov tsim nyog.

Cov tsos mob ntawm tus menyuam mos tshiab

Yog tias tus menyuam mos liab muaj cov tsos mob no hauv ob peb hnub tom qab yug los, tus kws kho mob yuav kuaj xyuas cov ammonia:

• Tsis so tsis so, quaj tsis tu ncua, thiab tsis kam haus mis (Kev chim siab)
• Ntuav
• Kev tsaug zog tsis taus, qaug zog, nyuaj sawv
• Qaug dab peg

Yog tias ib tug me nyuam muaj cov tsos mob no, tsis txhob tsis quav ntsej lawv. Mus ntsib kws kho mob tam sim ntawd.

Vim li cas cov ammonia hauv lub cev thiaj li nce ntau heev?

Muaj ntau yam ua rau cov ammonia hauv cov ntshav nce ntxiv. Cia peb saib seb lawv yog dab tsi:

• Kab mob siab:Qhov no yog qhov laj thawj tseem ceeb . Yog tias koj lub siab puas lawm, xws li mob cirrhosis, lub siab tsis tuaj yeem tshem tawm ammonia kom zoo. Qhov no feem ntau yog qhov teeb meem nrog kab mob siab hnyav. Txawm li cas los xij, qee zaum, txawm tias kab mob siab ruaj khov, yog tias muaj qee yam tshwm sim hauv lub plab lossis txoj hnyuv, xws li kev los ntshav hauv plab hnyuv, lossis kev tsis sib npaug ntawm electrolyte, cov ammonia tuaj yeem nce siab tam sim ntawd.

• Txo cov ntshav ntws mus rau lub siab: Yog tias lub siab tsis tau txais ntshav txaus, ammonia yuav tsis mus txog lub siab thiab raug ntxuav. Tom qab ntawd, ammonia yuav sib sau ua ke hauv cov ntshav.

• Kab mob siab (hepatic encephalopathy): Qhov no nyuaj me ntsis. Hais yooj yim xwb, thaum lub siab muaj kab mob lossis puas tsuaj thiab tsis tuaj yeem tshem tawm ammonia kom zoo, ammonia yuav sib sau ua ke hauv cov ntshav thiab mus rau lub hlwb. Qhov no tuaj yeem ua rau tsis nco qab, tsis meej pem, thiab tsis nco qab. Qee zaum nws tuaj yeem ua rau tuag taus.

• Reye's syndrome: Qhov no yog ib qho mob tsis tshua muaj tab sis loj heev uas cuam tshuam rau cov ntshav, lub hlwb, thiab daim siab. Feem ntau nws ua rau cov ntshav ammonia ntau thiab cov ntshav qab zib qis. Feem ntau nws tshwm sim rau cov menyuam yaus thiab cov tub ntxhais hluas uas tau noj aspirin rau cov tsos mob thaum rov zoo los ntawm tus kab mob viral xws li mob qaib ntxhw lossis mob khaub thuas (mob ntsws). Qhov ua rau muaj Reye's syndrome tsis paub meej. Txawm li cas los xij, vim muaj qhov kev pheej hmoo no, cov menyuam yaus thiab cov tub ntxhais hluas yuav tsum tsis txhob noj aspirin tshwj tsis yog tus kws kho mob pom zoo.

• Lub raum / lub raum tsis ua haujlwm zoo: Yog tias koj lub raum tsis ua haujlwm zoo, txhais tau tias lawv tsis ua haujlwm zoo, lawv tsis tuaj yeem tshem tawm cov urea kom zoo. Qhov no ua rau ammonia sib sau ua ke hauv cov ntshav.

• Cov kab mob caj ces ntawm lub voj voog urea: Muaj cov kab mob caj ces tsawg heev. Cov no yog tshwm sim los ntawm qhov tsis txaus ntawm ib qho ntawm cov enzymes uas xav tau rau lub voj voog urea. Qhov no feem ntau pom thaum yug los.

• Kab mob hemolytic ntawm tus menyuam mos: Qhov no tshwm sim thaum niam cev xeeb tub tsim cov tshuaj tiv thaiv kab mob tawm tsam nws tus menyuam cov qe ntshav. Qhov mob no tuaj yeem tiv thaiv tau. Yog tias koj yog Rh-negative thiab tsis tau raug kev ua xua ua ntej, koj tuaj yeem noj tshuaj uas tiv thaiv koj cov tshuaj tiv thaiv kab mob kom tsis txhob cuam tshuam nrog koj tus menyuam cov qe ntshav Rh-positive.

Cov kev kho mob rau cov ammonia ntau dhau yog dab tsi?

Kev kho mob rau cov ammonia ntau ntxiv nyob ntawm seb ua li cas. Piv txwv li, rau ib tug neeg laus, nws yuav yog vim muaj kab mob siab lossis mob hlwb hepatic, thaum rau ib tug menyuam mos, nws yuav yog vim muaj mob txij thaum yug los uas cuam tshuam rau lub voj voog urea.

Thaum kho cov kab mob hyperammonemia hnyav heev, qhov tseem ceeb tshaj plaws yog txo cov ammonia thiab tswj cov teeb meem xws li cerebral edema thiab intracranial hypertension.

Yog tias tus menyuam mos qib ammonia nce ntxiv, cov kws kho mob yuav tsum tsis txhob muab protein rau lawv (vim tias ammonia raug tsim tawm thaum cov protein raug zom). Hloov chaw, lawv muab cov kua glucose rau lawv kom muaj zog. Lawv kuj siv kev kho mob hu ua hemodialysis los tshem tawm ammonia ntawm cov ntshav ntawm tus menyuam. Qhov no suav nrog kev ntxuav cov ntshav siv lub tshuab tshwj xeeb hu ua lub tshuab dialysis thiab lub lim dej, xws li lub raum cuav.

Thaum kho tus kab mob hepatic encephalopathy, lub hom phiaj yog kom txo qhov tsim cov ammonia hauv cov hnyuv. Kab kev kho mob thawj zaug yog cov tshuaj noj hu ua lactulose thiab lactitol . Cov suab thaj no txo ​​qhov tsim thiab nqus cov ammonia hauv cov hnyuv.

Thaum twg kuv yuav tsum mus ntsib kws kho mob txog kuv cov ammonia?

Qhov no meej heev. Yog tias koj lossis ib tus neeg ze koj muaj cov tsos mob ntawm cov ntshav ammonia ntau, xws li kev tsis meej pem uas peb tau tham txog ua ntej, kev tsaug zog tas li, thiab kev hloov pauv hauv kev nco qab, hu rau 911 tam sim ntawd, lossis mus rau chav kho mob ceev hauv tsev kho mob ze tshaj plaws sai li sai tau. Qhov no tsis yog ib yam dab tsi uas yuav tsum ncua sijhawm.

Yog koj muaj kab mob siab, koj yuav tsum mus ntsib koj tus kws kho mob tsis tu ncua kom paub tseeb tias koj lub siab tshem tawm cov ammonia kom zoo. Qhov no yuav pab koj txheeb xyuas cov teeb meem thaum ntxov.

Yog li ntawd, tej yam tseem ceeb tshaj plaws uas peb yuav tsum nco ntsoov los ntawm zaj dab neeg no yog dab tsi?

Txawm hais tias nws yog ib qho ib txwm rau peb lub cev tsim cov ammonia ua cov khoom pov tseg, nws tuaj yeem ua rau muaj kev phom sij heev yog tias nws sib sau ua ke hauv cov ntshav ntau dhau.

Yog tias koj lossis ib tus neeg ze koj muaj cov tsos mob ntawm cov ammonia ntau (piv txwv li, tsis meej pem, tsaug zog ntau dhau, hloov tus cwj pwm), mus rau tsev kho mob ze tshaj plaws sai li sai tau yam tsis muaj kev ncua. Qhov no tuaj yeem yog qhov xwm txheej tuag taus.

Nws yog ib qho tseem ceeb heev uas yuav tsum paub txog cov tsos mob no yog tias koj muaj kab mob siab, vim qhov no tuaj yeem ua rau muaj kev pheej hmoo ntawm cov ammonia ntau ntxiv.

Yog tias koj muaj lus nug txog kev pheej hmoo ntawm cov ammonia ntau ntxiv, lossis lwm yam uas koj xav paub, tsis txhob yig tham nrog koj tus kws kho mob. Lawv nyob ntawd los pab koj thiab teb koj cov lus nug. Kev noj qab haus huv yog qhov tseem ceeb tshaj plaws!

` Ammonia, Cov Qib Ammonia, Siab, Raum, Urea Cycle, Hepatic Encephalopathy, Reye's Syndrome, Kuaj Ntshav, Hyperammonemia